Monitoring neurological functional status

ABSTRACT

A device for measuring eye movement in a human subject comprises a housing, at least one stimulator mounted to the housing, and a sensor. The at least one stimulator is configured to provide stimulus to one or both eyes of the subject. The sensor is configured to collect information related to movement of one or both eyes of the subject. The device also includes a user interface that is configured to control the at least one stimulator and display information collected by the camera.

REFERENCE TO RELATED APPLICATION

This application is a continuation of U.S. patent application Ser. No.14/787,564, filed on Oct. 28, 2015, which is a national stage filing ofInternational Application No. PCT/US2014/036349 filed on May 1, 2014,which claims priority to U.S. Provisional Patent Application No.61/818,087, filed May 1, 2013, each of which are incorporated herein byreference in their entireties.

BACKGROUND

Mild traumatic brain injury (mTBI), sometimes referred to as aconcussion, mild brain injury, mild head injury (MHI), or minor headtrauma, is the most common type of traumatic brain injury. The rate atwhich mTBI occurs is not accurately known, which may be due to thesubjective nature of its detection and diagnosis, and the possibilitythat occurrences of mTBI are being under-reported. Some estimatessuggest that mTBI occurs in more than six (6) per one thousand (1,000)people per year. Common causes of concussions are sports injuries,bicycle accidents, car accidents and falls. Concussions caused by sportsinjuries and bicycle injuries most commonly occur in children and youngadults, and those caused by car accidents and falls most commonly occurin adults and the elderly.

Part of the problem of the diagnosis of mTBI is that there are littledifferences between the diagnostic criteria and the manifest symptoms.mTBI implies decreased cognitive function and denotes change inpersonality and behaviors that are uncharacteristic of the person whohas sustained an mTBI. While there are known systems and methods foridentifying or measuring cognitive function in a subject, there arecurrently no devices and methods that objectively measure, on a nearreal-time basis in the field (e.g., the playing field, battlefield, siteof an automobile accident, etc.), the likelihood of altered brainreflexes and/or physiology associated with a neurological conditionwithin a subject.

SUMMARY

A device for measuring a reflex reaction in a subject suspected ofsuffering from mTBI is disclosed. In particular, the device measures areflex reaction in a subject that has suffered an injury and comparesthat reaction to a baseline reaction in the same subject taken prior tosuffering the injury.

In one embodiment reflexive eye movement is tracked. The device formeasuring such movement comprises a housing, at least one stimulatormounted to the housing, and a tracking sensor that measures the eyemovement, such as a camera. The at least one stimulator is configured toprovide stimulus to one or both eyes of the subject producing thedesired reaction. The tracking device, in this example a camera, isconfigured to collect information related to movement of one or botheyes of the subject. The device also includes a user interface that isconfigured to control the at least one stimulator and displayinformation collected by the camera.

In another embodiment, a device for measuring blink reflex in a humansubject comprises a camera configured to track movement of one or botheyelids of the subject, a stimulator configured to provide stimulus toone or both eyelids of the subject, and one or more processors. The oneor more processors execute instructions to track the movement of the oneor more eyelids using the camera, stimulate the subject using thestimulator to provoke a first blink reflex, the first blink reflexcorresponding to an involuntary blink, of the one or more eyelids,determine, based on information received from the camera, a first timeperiod being associated with the first blink reflex, calculate andabsolute difference between the first time period and a second timeperiod, the second time period being associated with a second blinkreflex of the subject, the second blink reflex measured when the subjectwas known not to be suffering from a neurological condition, determine,based on obtaining the second information, whether the subject ispotentially suffering from a neurological condition based on adifference between the first time period and the second time periodrelative to a threshold, and provide an indication that the subject issuffering from a neurological condition when the difference between thefirst time period and the second time period, is greater than thethreshold.

In yet another embodiment, a method for measuring a blink reflex of asubject using a blink reflex device comprises stimulating one or botheyes of the subject using at least one stimulator so as to cause aninvoluntarily blink response in the subject, measuring a time periodfrom the stimulating step to when one or both eyes initiates theinvoluntary blink response, and displaying information that identifiesthe time period.

BRIEF DESCRIPTION OF THE DRAWINGS

FIGS. 1A-1D are diagrams of an example embodiment of the blink reflexdevice;

FIG. 2 is a diagram of an example environment in which the blink reflexdevice shown in FIGS. 1A-1D may be implemented;

FIG. 3 is a diagram of example components of a blink reflex device ofFIG. 1A-1D;

FIG. 4 is a diagram of example components that may correspond to one ormore of the devices and/or components of FIGS. 1A-3 ;

FIG. 5 is a diagram of an example modules that may be associated with astimulator component of FIG. 1A-1D;

FIG. 6A is a diagram of an example eyelid tracking scheme associatedwith measuring a blink reflex of a subject;

FIG. 6B is a diagram of example stages of a blink of an eye of a subjectfrom which a blink reflex can be measured;

FIG. 6C is a diagram of an example blink reflex response associated witha subject;

FIGS. 7A-7D are diagrams of example blink reflex devices associated withdifferent stimulator modules;

FIGS. 8A-8D are diagrams of different types of example blink reflexresponses associated with a subject;

FIG. 9 is a diagram of an example blink reflex response, associated witha subject, that includes data to be removed and/or filtered from theexample blink reflex response;

FIG. 10 is a flowchart of an example process for determining whether asubject suffers from brain injury or a degenerative neurologicalcondition;

FIG. 11 is a diagram of an example data structure that may storeinformation associated with a blink reflex of a subject; and

FIG. 12 is a diagram of an example data structure that storesinformation associated with a change in blink reflex of a subject.

DETAILED DESCRIPTION

The devices and methods described herein may be used to determinewhether a human subject suffers from impaired neurological functionbased on a change in a blink reflex, blink period, or other brain reflexof the subject. Impaired neurological function may result from a braininjury, such as mTBI, SIS, impaired neurological function (e.g., due tofatigue, exhaustion, a developmental abnormality, an illness other thana neurological illness, etc.) and/or a degenerative neurologicalcondition such as Alzheimer's disease and Parkinson's disease(hereinafter collectively referred to as a “neurological condition”). Inthe event that it is determined that the subject may suffer from aneurological condition, the devices and methods may enable a level ofseverity of such a neurological condition.

FIGS. 1A-1D are diagrams of an example blink reflex device 100. As shownin FIG. 1A, blink reflex device 100 may include a housing 101, astimulator 102, and a sensor 215 (shown in FIG. 1B), such as a camera.With reference to FIG. 2 , blink reflex device 100 may communicate withserver 120 and/or database 130 via network 140. Blink reflex device 100may include a collection of components such as, for example, a userinterface 103, a handle 104, and a screen 105 (shown in FIG. 1B).

Device 100 may include a flexible material 106 attached to the housing101 configured to fit against the face, head, or neck of the subject.Flexible material 106, together with housing 101, defines a cavitywithin which the stimulators 102, sensor 215, and screen 105 aredisposed. Flexible material 106 conforms to the shape and contours ofthe subject so as to create a temporary seal between the subject andblink reflex device 100. The seal may enable stimulator 102 and orsensor 215 (shown in FIG. 1B) to operate with minimal externalstimulation or light. Screen 105 may also, or alternatively, minimizethe likelihood that the subject is distracted by objects or activitiesthat are outside the cavity. Handle 104 may include a rigid materialthat is part of or connect to housing 101 configured to be held by anoperator of the blink reflex device 100. User interface 103 allows theoperator to operate and/or control blink reflex device 100.

By way of example, an operator, of blink reflex device 100, may placeblink reflex device 100 against the subject's face to detect and monitorone or both eyes of the subject to measure and/or obtain informationassociated with a blink reflex and/or blink period of the subject (e.g.,as shown in FIG. 1D). FIG. 1B, which depicts section AA of blink reflexdevice 100 as shown in FIG. 1A, depicts a pair of stimulators 102,sensor 215, screen 105, and a divider 107. Stimulators 102 providemechanical stimuli (e.g., a puff of fluid, etc.) and/or some other typeof stimuli (e.g., light, acoustic, electrical, etc.) to the subject.Sensor 215 measures the blink reflex and/or blink period of the subject.Sensor 215 may also, or alternatively, measure eye movement and/orpupillary response of the subject. Sensor 215 may also use facialrecognition to identify a subject.

Stimulator 102 may include one or more components to provide mechanical,electrical, optical, and/or acoustic stimulation to a subject, totrigger a blink reflex in the subject. The stimulation may excitecertain neural pathways in the brain and/or nervous system of thesubject, which may trigger the blink reflex. For example, opticalstimulation (e.g., due to a beam of bright light to the eye of thesubject) may stimulate the superior colliculus structure and/or someother structure in the brain to cause the subject to involuntarilyblink. Additionally, or alternatively, mechanical stimulation (e.g., apuff of air to the eye, a pin prick or tap to the proximity of the eye,etc.) and/or electrical stimulation may excite the corneal reflex and/orsome neurological structure of the subject causing the subject toinvoluntarily blink. Additionally, or alternatively, acousticstimulation (e.g., a sudden loud tone, noise, music, etc.) may stimulatethe inferior colliculus structure and/or some other structure in thebrain to cause the subject to involuntarily blink or elicit some otherbrain reflex. Stimulator 102 may output the stimulation based on aninstruction received from processing unit 200 (shown in FIG. 3 ) and/ora user of blink reflex device 100. Stimulator 102 may also, oralternatively, include a device to confound or distract the subject toattenuate a tendency by the subject to anticipate certain stimuli, whichmay affect the integrity of the blink reflex data and/or other brainreflex data.

With reference to FIG. 5 , example modules that may be associated with astimulator 102 are shown. Stimulator 102 may include a mechanical module410, a light module 420, an acoustic module 430, an electrical module440 and/or a confounder module 450. Although FIG. 5 shows examplemodules of stimulator 102, additionally, or alternatively, stimulator102 may include fewer modules, additional modules, different modules, ordifferently arranged modules than depicted in FIG. 5 . Additionally, oralternatively, one or more modules of stimulator 102 may perform one ormore tasks described as being performed by one or more other modules ofstimulator 102.

Divider 107 forms a barrier between a right side and left side of thecavity defined by the flexible material preclude stimulus, provided byone of the stimulators 102, from inadvertently stimulating the eye thatis closest to the other stimulator 102. Divider 107 is configured suchthat sensor 215 can measure the blink reflex, blink period, eyemovement, or pupillary response of one or both eyes of the subject.Divider 107 may be made of a flexible material that conforms to theshape of the subjects face, nose, forehead, etc. Divider 107 may also,or alternatively, be removable.

With reference to FIG. 1B, screen 105 may be used to displayinstructions for the subject during a confounding operation ormeasurement, a target can be displayed at which the subject is to stareat or track during a measurement, etc. Screen 105 may enable questions,lights, etc. associated with a confounding operation to be displayed forthe subject. Screen 105 may provide means of optical stimulus in placeof or in combination with stimulus provided by stimulator 102.

As shown in FIG. 1C, user interface 103 may include a collection ofbuttons, fields and/or indicators, such as a power button 103 a, astimulator button 103 b, a stimuli selector button 103 c, an eyeselector button 103 d, a measure button 103 e, an indicator 103 f, and asubject field 103 g. User interface 103 may receive information fromprocessing unit 200 (shown in FIG. 3 ) and may display the receivedinformation. User interface 103 may receive information from an operatorof blink reflex device 100 and may provide the entered information toprocessing unit 200. The number of components, buttons, fields and/orindicators, illustrated in FIG. 1C is provided for explanatory purposesonly. In practice, there may be additional components, fields, buttons,and/or indicators; fewer components, fields, buttons, and/or indicators;different components, fields, buttons, and/or indicators; or differentlyarranged components, fields, buttons, and/or indicators than illustratedin FIG. 1C.

Power button 103 a may include one or more buttons that enable blinkreflex device 100 to power up or power down. Stimulator button 103 benables the operator to control blink reflex device 100 to providestimulus to the subject or to preclude stimulus from being provided tothe subject.

Stimuli selector button 103 c enables selection of a type of stimulus(e.g., mechanical, electrical, acoustic, optical, etc.) to be providedto the subject by blink reflex device 100. Stimuli selector button 103 cmay also, or alternatively, enable control of whether or not blinkreflex device 100 will provide confounding to the subject. Eye selectorbutton 103 d may enable selection of the left eye, right eye, or botheyes from which information associated with a blink reflex and/or blinkperiod is to be obtained by blink reflex device 100. Measure button 103e, when selected by the user, causes blink reflex device 100 to measurethe blink reflex and/or blink period of the subject in a manner thatincludes the type of stimuli with or without confounding as selected bythe user using stimuli selector button 103 c. Indicator 103 f mayinclude one or more lights, light emitting diodes, a display, a userinterface, speaker, etc. that enables blink reflex device 100 to outputan indication, notification, and/or sound that can be viewed or heard byan operator of blink reflex device 100 that identifies whether thesubject suffers from a neurological condition and/or a level of severityof such a neurological condition. For example, if blink reflex device100 determines that the subject likely suffers from some brain injury ordegenerative neurological condition that is not significant, blinkreflex device 100 may cause a light, indication, notification, etc. tobe lighted or displayed in a manner that indicates that the subjectsuffers from some brain injury or degenerative neurological condition.Subject field 103 g may include an image or video of the subject as seenby sensor 215 before, during, and/or after measurements are taken on thesubject.

FIG. 1D is a diagram of blink reflex device 100 being used to take ablink reflex and/or blink period measurement from the subject. As shownin FIG. 1D, the operator may place blink reflex device 100 against theface of the subject to obtain information associated with the blinkreflex and/or blink period in a manner described above.

Device 100 and its associated methods may enable, for example, a blinkreflex device to measure a response associated with an eye blink of asubject (hereinafter the “blink reflex”). The blink reflex (described ingreater detail herein) may generally correspond to a time period fromwhen stimulation (described herein) is received by the subject withinthe proximity of the eye of the subject to when the subject initiates orbegins to blink (e.g., when one or more of the subject's eyelids, in anopen state, begin to close) in response to the stimulation.

Device 100 and its associated methods may enable a blink reflex deviceto measure a period of time that it takes for the subject to blink hisor her eye (hereinafter, the “blink period”). The blink period may be onthe subject's response to stimulation; intentional and voluntary blink;and/or involuntary, unintentional or subconscious blink. The blinkperiod may be measured from when the subject starts to blink (e.g., whenthe eyelid, in an open state, begins to close) to when the subject stopsthe blink and the eye of the subject returns to the open state (e.g.,when the eyelid, returning from a closed state, stops opening).

Device 100 and its associated methods may also, or alternatively, enablethe blink reflex device to detect when the subject exhibits an abnormalblink and may reject, discard, and/or ignore any data associated with ablink reflex measurement of the abnormal blink or other non-reflexclosure or movement of the eye. An abnormal blink may occur when the eyeof the subject does not fully return to the open state, does not fullyclose, remains closed for a prolonged time period (e.g., greater than 2times, 5 times, 10 times, 15 times, etc. of a normal blink period)(sometimes referred to as a “micro-sleep”).

Device 100 and its associated methods may enable the blink reflex deviceto measure the blink reflex for either eye (unilateral) or both eyes(bilateral) of the subject based on an intentional blink by the subject(e.g., a conscious blink in response to a command), a spontaneous blinkof the subject (e.g., an unconscious blink to moisten or lubricate theeye), or a reflexive blink of the subject in response to one or moredifferent types of stimulation (e.g., electrical, mechanical, acoustic,optical, or some other type of stimulation) directly to the eye, eyelid, eye lashes, or proximity of the eye (e.g., within ¼, ½, 1, 2, etc.inches of the eye or eyelid). The different types of stimulation maytrigger different neural pathways within, and/or neurological functionsof, the brain to cause the blink reflex. Thus, measuring the blinkreflex using different types of stimulation may enable a type ofneurological impairment within the brain to be identified and/or aspecific location or structure, within the brain, that has been injuredor impaired, to be identified.

Device 100 and its associated methods may enable the blink reflex deviceto compare the measured blink reflex, blink period, or a brain reflex toa baseline blink reflex, blink period, or some other brain reflex toidentify an amount difference between the measured blink reflex, blinkperiod, or brain reflex and the baseline blink reflex, blink period, orsome other brain reflex, respectively The baseline measurement maycorrespond to a blink reflex, blink period, or brain reflex that ismeasured from the subject at a time when the subject is known not to besuffering from a neurological condition. For example, the baseline blinkreflex, blink period, or brain reflex may be measured prior to theoccurrence of a traumatic event, such as a blow to the head of thesubject (e.g., on the field of play, on the battlefield, in a caraccident, a physical altercation, etc.). Device 100 and its associatedmethods may also, or alternatively, enable the blink reflex device todetermine whether the subject suffers from a neurological conditionand/or the severity thereof based an amount of change between themeasured blink reflex, blink period or brain reflex, and the baselineblink reflex, blink period and/or some other brain reflex, respectively.Additionally, or alternatively, the blink reflex device may enable thetype of neurological condition and/or specific locations in the brainthat have be injured to be identified based on a respective amount ofchange of the blink reflex, blink period and/or brain reflex for each ofthe different types of stimulation. Device 100 and its associatedmethods may also, or alternatively, enable the type of neurologicalcondition and/or specific locations or structures of the brain that havebeen injured to be identified based on differences in the blink reflexand/or blink period between the left and right eye. Over time, device100 and its associated methods may enable the blink reflex device totrack changes in the baseline blink reflex, blink period, and/or brainreflex as a subject ages or is repeatedly exposed to brain orneurological trauma.

Additionally, or alternatively, device 100 and its associated methodsmay enable the blink reflex device to identify the type of degenerativeneurological disorder based on an amount of change in non-stimulatedblink period (e.g., between measured and baseline blink period) based onan intentional blink and/or spontaneous blink. Additionally, oralternatively, device 100 and its associated methods may enable a blinkreflex device to sense and/or monitor the eye of the subject to measurethe blink reflex, blink period, eye movement (e.g., the rate and/oramount of angular rotation of the eye), pupillary response (e.g., therate and/or amount in which the pupil of the eye changes size), and/orbrain activity (e.g., electrical signals of the brain, brain waves,etc.). The blink reflex device may detect potential impairedneurological function and/or the severity thereof based on a combinationof changes in blink reflex and/or blink period and one or more otherresponses, such as changes in the subject's pupillary response, eyemovement response, and/or changes in level of brain activity.

Device 100 and its associated methods may enable the blink reflex deviceto detect the potential for a neurological condition in a subject basedon measuring the ability of the subject to normally respond toblink-inducing stimuli and/or spontaneous blink rates. Device 100 andits associated may enable the blink reflex device to aid a medicalpractitioner and/or user to determine the integrity of the afferentsensory system entering the brainstem of the subject, the efferent motorfunction of the subject, as well as general homeostasis maintenanceactivity, such as blink in lubrication of the eye. Thus, the change inblink reflex as measured by the blink reflex device, may provide theuser in the field a decision aid regarding whether to permit a player toreturn to the playing field and/or the medical practitioner insight intowhether and to what extent the deep brain structures have been alteredor injured due to a traumatic event to the subject.

Device 100 and its associated methods, described herein, may enable adetermination of whether a subject potentially suffers from a braininjury and/or a degenerative neurological condition. Device 100 and itsassociated methods may enable a blink reflex device to obtaininformation associated with a blink or other brain reflex, blink period,eye movement, or pupillary response of a subject. Device 100 and itsassociated methods may also, or alternatively, enable the blink reflexdevice to detect when the subject exhibits an abnormal blink (e.g., amicro-sleep, a double blink, etc.) and may reject, discard, and/orignore any data, that corresponds to an abnormal blink. Device 100 andits associated methods may enable the blink reflex device to measure theblink reflex and/or blink period for either or both eyes of the subjectbased on an intentional blink by the subject, a natural blink of thesubject, or a reflexive blink of the subject in response to one or moredifferent types of stimuli (e.g., mechanical, light, acoustic,electrical, or some other type of stimuli).

Device 100 and its associated methods may enable the blink reflex deviceto compare information associated with a blink reflex and/or blinkperiod obtained prior to a traumatic event experienced by the subject,with information associated with the blink reflex and/or blink periodobtained after the traumatic event to identify an amount of changebetween the blink reflex and/or blink period before and after thetrauma. Device 100 and its associated methods may also, oralternatively, enable the blink reflex device to determine whether thesubject suffers from a neurological condition and/or the severitythereof based an amount of change in the blink reflex before and afterthe trauma relative to one or more thresholds. Additionally, oralternatively, the blink reflex device may lend insight into a type ofbrain injury and/or specific locations in the brain that have beeninjured as a result of the trauma based on a respective amount of changeof the blink reflex and/or blink period for each of the different typesof stimulation to the subject and/or based on differences in the blinkreflex between the left and right eye.

Additionally, or alternatively, device 100 and its associated methodsmay enable the blink reflex device may lend insight into a type ofdegenerative neurological disorder based on an amount of change innon-stimulated blink reflex before and after trauma based on anintentional blink and/or spontaneous blink without stimulation.Additionally, or alternatively, device 100 and its associated methodsmay enable a blink reflex device to sense and/or monitor the eye of thesubject to measure the blink reflex, blink period, eye movement (e.g.,the rate and/or amount of angular rotation of the eye), pupillaryresponse (e.g., the rate and/or amount in which the pupil of the eyechanges size), and/or brain activity (e.g., electrical signals of thebrain, brain waves, etc.). The blink reflex device may detect aneurological condition, and/or the severity thereof based on acombination of changes (e.g., before and after the subject experiences atraumatic event) in blink reflex and/or blink period relative to certainthresholds, and one or more known responses, such as changes in thesubject's pupillary response, eye movement response, and/or brainactivity, etc.

Device 100 and its associated methods may enable the blink reflex deviceto aid a user of the blink reflex device to determine the integrity ofthe afferent sensory system entering the brainstem of the subject aswell as the efferent motor function of the subject. Thus, the change inblink reflex as measured by the blink reflex device, may provide theuser in the field a decision aid regarding whether to permit a player toreturn to the playing field and/or the medical practitioner insight intowhether and to what extent the deep brain structures have been alteredor injured due to a traumatic event to the subject.

Device 100 and its associated methods may enable the blink reflex deviceto measure the blink reflex, blink period, and/or other brain reflex onan aggregate, population level to determine typical norms indevelopment, growth, and/or aging processes and compare it to blinkreflex and blink period numbers experienced by individual subjects. Themetric obtained can be used to quantify deviations from population normsthat will allow quantifiable measures of diagnoses that are currentlydescribed qualitatively.

FIG. 2 is a diagram of an example environment E in which the devices andmethods, described herein, may be implemented. As shown in FIG. 2 ,environment E may include a group of user devices 110-1, . . . , 110-J(collectively referred to herein as “user devices 110,” and individuallyas “user device 110”) (where J≥1) a group servers 120-1, . . . , 120-K(collectively referred to herein as “servers 120” and individually as“server 120”) (where K≥1), a blink reflex device 100 and a database 130,some or all of which are interconnected by a network 140. The number ofdevices and/or networks, illustrated in FIG. 2 , is provided forexplanatory purposes only. In practice, there may be additional networksand/or devices, fewer networks and/or devices, different networks and/ordevices, or differently arranged networks and/or devices thanillustrated in FIG. 2 .

Also, in some implementations, one or more of the devices of environmentE may perform one or more functions described as being performed byanother one or more of the devices of environment E. Components ofenvironment E may interconnect via wired connections, wirelessconnections, or a combination of wired and wireless connections.

User device 110 may include any computation or communication device,such as a wireless mobile communication device, that is capable ofcommunicating with network 140. For example, user device 110 may includea radiotelephone, a personal communications system (PCS) terminal (e.g.,such as a smart phone that may combine a cellular radiotelephone withdata processing and data communications capabilities), a personaldigital assistant (PDA) (e.g., that can include a radiotelephone, apager, Internet/intranet access, etc.), a laptop computer, a tabletcomputer, a personal computer, a camera, a personal gaming system, oranother type of computation or communication device.

User device 110 may further perform communication operations by sendingdata to or receiving data from another device, such as some other userdevice 110, server 120, blink reflex device 100, and/or database 130.User device 110 for example, receive an indication from blink reflexdevice 100 and/or server 120 that indicates whether and/or to what levelof severity the subject suffers from a neurological condition. Data mayrefer to any type of machine-readable information having substantiallyany format that may be adapted for use in one or more networks and/orwith one or more devices. Data may include digital information or analoginformation. Data may further be packetized and/or non-packetized. Userdevice 110 may include logic for performing computations on user device110 and may include the components illustrated in FIG. 2 in an exampleimplementation.

Server 120 may include one or more server devices, or other types ofcomputation or communication devices, that gather, process, search,store, and/or provide information in a manner described herein. Server120 may communicate via network 140. Server 120 may receive from network140 and/or blink reflex device 100 blink reflex information associatedwith a blink reflex of a subject (e.g., before and/or after a traumaticevent to the head or spine of the subject) and may store such blinkreflex information in a memory associated with server 120 and/ordatabase 130. Server 120 may also, or alternatively, compare measuredblink reflex information associated with a subject with baseline blinkreflex information associated with the subject (e.g., obtained fromdatabase 130) and/or other subjects (e.g., obtained prior to a traumaticevent experienced by the subject and/or other subjects and/or at a timethat it was known that the subject and/or other subjects did not sufferfrom neurological condition to identify an amount of change between themeasured blink reflex and the baseline blink reflex. Server 120 may,based on the amount of change between the measured blink reflex and thebaseline blink reflex, determine whether and/or to what level ofseverity the subject may suffer from a brain injury and/or adegenerative neurological condition. Server 120 may provide anindication to blink reflex device 100, user device 110, or anotherserver 120 indicating whether and/or to what level of severity thesubject potentially suffers from a brain injury and/or a degenerativeneurological condition.

Blink reflex device 100 may include one or more components that arecapable of obtaining, measuring, or generating certain biometricinformation relating to a subject and communicating with network 140.For example, blink reflex device 100 may include a radiotelephone, apersonal communications system (PCS) terminal (e.g., such as a smartphone that may combine a cellular radiotelephone with data processingand data communications capabilities), a personal digital assistant(PDA) (e.g., that can include a radiotelephone, a pager,Internet/intranet access, etc.), a laptop computer, a tablet computer, apersonal computer, a camera, a personal gaming system, or another typeof computation or communication device. Additionally, or alternatively,blink reflex device 100 may include one or more sensor components todetect all or a portion of the subject's body (e.g., all or portions ofthe subject's eyes, face, head, etc.) for the purposes of measuring ablink reflex, blink period, pupillary response, eye movement, subjectidentity, etc. associated with the subject. Blink reflex device 100 mayalso, or alternatively, include one or more components, to be describedin greater detail in FIGS. 2 and 4 , that may mechanically,electrically, optically, or acoustically stimulate the subject to causethe blink reflex in the subject.

Blink reflex device 100 may obtain blink reflex information from thesubject (e.g., after a traumatic event to the head and/or spine of thesubject) and may compare such information to other blink reflexinformation (e.g., baseline blink reflex information) associated with ablink reflex of the patent and/or other subjects (e.g., prior to anytrauma and/or at a time when it was known that the subject did notsuffer from impaired neurological function) to determine whether thesubject suffers from a neurological condition. Blink reflex device 100may communicate with server 120, database 130 and/or user device 110,via network 140, to transmit or receive information associated with ablink reflex of the subject and/or baseline blink reflex informationassociated with one or more other subjects. Additionally, oralternatively, blink reflex device 100 may include logic, such as one ormore processing or storage devices, that can be used to perform and/orsupport processing activities in connection with the operation describedherein.

Database 130 may include one or more devices that store informationreceived from blink reflex device 100, and/or server 120. For example,database 130 may store information associated with a blink reflex, blinkperiod, eye movement, pupil response, etc. relating to one or moresubject. Database 130 may also, or alternatively, store in formationassociated with the subject (e.g., name, age, gender, race, etc.),information associated with test conditions or parameters (e.g., with orwithout confounding, a type of stimulation, a type of measurement,etc.), and/or information describing a type of trauma or condition(e.g., football injury, automobile accident, pre-existing conditionsuffered by subject, etc.).

Network 140 may include one or more wired and/or wireless networks. Forexample, network 140 may include a cellular network, a public landmobile network (PLMN), a second generation (2G) network, a thirdgeneration (3G) network, a fourth generation (4G) network (e.g., a longterm evolution (LTE) network), a fifth generation (5G) network, and/oranother network. Additionally, or alternatively, network 140 may includea wide area network (WAN), a metropolitan network (MAN), a telephonenetwork (e.g., the Public Switched Telephone Network (PSTN)), an ad hocnetwork, an intranet, the Internet, a fiber optic-based network, and/ora combination of these or other types of networks.

FIG. 2 is a diagram of example components of blink reflex device 100. Asshown in FIG. 2 , blink reflex device 100 may include a processing unit200, a stimulator 102, a memory 210, a sensor unit 215, a user interface220, a communication interface 230, and/or an antenna assembly 240.Although FIG. 2 shows example components of blink reflex device 100,additionally, or alternatively, blink reflex device 100 may includefewer components, additional components, different components, ordifferently arranged components than depicted in FIG. 2 . In still otherimplementations, one or more components of blink reflex device 100 mayperform one or more tasks described as being performed by one or moreother components of blink reflex device 100.

Processing unit 200 may include a processor, a microprocessor, anapplication specific integrated circuit (ASIC), a field programmablegate array (FPGA), or the like. Processing unit 200 may controloperation of blink reflex device 100 and its components. In oneimplementation, processing unit 200 may control operation of componentsof blink reflex device 100 in a manner similar to that described herein.For example, processing unit 200 may instruct stimulator 102 to apply amechanical, optical, acoustic or electrical stimulation to the subject.Additionally, processing unit 200 may repeat the instruction based on atime interval, randomly (e.g., based on a random number generated byprocessing unit 200), and/or in response to an instruction from a userof blink reflex device 100.

Memory 210 may include a RAM, a ROM, and/or another type of memory tostore data and/or instructions that may be used by processing unit 200.Memory 210 may store information associated with a blink reflex of asubject that is received from sensor unit 215, another component ofblink reflex device 100 and/or network 140.

Sensor unit 215 may include one or more components to detect, measure,scan, and/or record all or a portion of a body of a subject, such as,for example, the face, the eyes, a portion of one or both of the eyes(e.g., eyelid, a pupil, etc.), etc. For example, sensor unit 215 mayinclude one or more a cameras, photodiodes, electro-optical sensors,infrared sensors, ultraviolet sensors, laser diode sensors, electrodes,focal plan arrays (FPA), antenna, etc. to detect, measure, scan, and/orrecord the subject (e.g., the eye, eyelid, face, etc. of the subject) inone or more portions of the electromagnetic spectrum (e.g., ultraviolet,visual, thermal, far infrared, microwave, electrical, x-ray, etc.).Sensor unit 215 may include a field of view, directivity, scan rate(e.g., scans per minute, per second, etc.), pixel density (e.g., pixelsper line or array), spectral range, dynamic range, level of resolution(e.g., dots per inch), a frame rate, a shutter speed, gain control, etc.that enables the eye, eyelid, eyelashes, etc. of the subject to bedetected and tracked as a function of time before, during, and afterstimulation is applied and/or the subject intentionally orunintentionally blinks. In one example, sensor unit 215 may measureinformation associated with a blink reflex of the subject and mayprovide such information to processing unit 200. Additionally, oralternatively, sensor unit 215 may measure other information associatedwith eye movement, pupillary response, brain waves, etc. associated withthe subject and may provide such other information to processing unit200.

User interface 220 may include one or more components that enableinformation to be input blink reflex device 100 and/or for outputtinginformation from blink reflex device 100. For example, user interfacemay include buttons, a touch screen, control buttons, a keyboard, apointing device, etc. to enable a user, of blink reflex device 100, toinput information associated with a measurement (e.g., type and/ormagnitude of stimuli; selection of right, left or both eyes, retrievalof information associated with baseline blink reflex, to power up, topower down, etc.) and/or to permit data and control commands (e.g., on,off, record, play, etc.) to be input into blink reflex device 100 viauser interface 220. User interface 220 may also, or alternatively,render video, images, audio, graphical, or textual informationassociated with a blink reflex of the subject for display to enable thesubject or medical practitioner to determine whether the subjectpotentially suffers from a neurological condition or the severitythereof.

Communication interface 230 may, for example, include one or morecomponents that enable blink reflex device 100 to communicate withnetwork 140 via transmit/receive 240. For example, communicationinterface 230 may include a transmitter that converts baseband signalsfrom processing unit 200 to signals (e.g., microwave signals, infraredsignals, etc.) that can be transmitted, via transmit/receive 240 tonetwork 140. Communication interface 230 may also, or alternatively,include a receiver that converts signals received from transmit/receive240 to baseband electrical or optical signals that can be processed byprocessing unit 200. Additionally, or alternatively, communicationinterface 230 may include a transceiver to perform functions of both atransmitter and a receiver of wireless communications (e.g., radiofrequency, infrared, visual optics, etc.), wired communications (e.g.,conductive wire, twisted pair cable, coaxial cable, transmission line,fiber optic cable, waveguide, etc.), or a combination of wireless andwired communications.

Transmit/receive 240 may include one or more antennas to transmit and/orreceive radio frequency (RF) signals over the air. Transmit/receive 240may, for example, receive RF signals from communication interface 230and transmit them over the air, and receive RF signals over the air andprovide them to communication interface 230. Additionally, oralternatively, transmit/receive 240 may include one or more opticaldevices to transmit and/or receive optical signals (e.g., visual,infrared, laser, ultraviolet, etc.) over the air. Transmit/receive 240may, for example, receive optical signals from communication interface230 and transmit them over the air, and/or receive optical signals overthe air and provide them to communication interface 230.

As described in detail below, blink reflex device 100 may performcertain operations described herein in response to processing unit 200executing software instructions of an application contained in acomputer-readable medium, such as memory 210. The software instructionsmay be read into memory 210 from another computer-readable medium orfrom another device via communication interface 230. The softwareinstructions contained in memory 210 may cause processing unit 200 toperform processes that will be described later. Alternatively, hardwiredcircuitry may be used in place of or in combination with softwareinstructions to implement processes described herein. Thus,implementations described herein are not limited to any specificcombination of hardware circuitry and software.

FIG. 4 is a diagram of example components of a device 300 that maycorrespond to user device 110, server 120, and/or blink reflex device100 (e.g., processing unit 200). Alternatively, each of user device 110,server 120, and/or blink reflex device 100 may include one or moredevices 300. Although FIG. 4 shows example components of device 300,additionally, or alternatively, device 300 may include fewer components,additional components, different components, or differently arrangedcomponents than depicted in FIG. 4 . Additionally, or alternatively, oneor more components of device 300 may perform one or more tasks describedas being performed by one or more other components of device 300.

Device 300 may include a bus 310, a processor 320, a memory 330, aninput component 340, an output component 350, and a communicationinterface 360. Although FIG. 4 shows example components of device 300,in other implementations, device 300 may contain fewer components,additional components, different components, or differently arrangedcomponents than depicted in FIG. 4 . For example, device 300 may includeone or more switch fabrics instead of, or in addition to, bus 310.Additionally, or alternatively, one or more components of device 300 mayperform one or more tasks described as being performed by one or moreother components of device 300.

Bus 310 may include a path that permits communication among thecomponents of device 300. Processor 320 may include a processor,microprocessor, or processing logic that may interpret and executeinstructions. Memory 330 may include any type of dynamic storage devicethat may store information and instructions, for execution by processor320, and/or any type of non-volatile storage device that may storeinformation for use by processor 320.

Input component 340 may include a mechanism that permits a user to inputinformation to device 300, such as a keyboard, a keypad, a button, aswitch, etc. Output component 350 may include a mechanism that outputsinformation to the user, such as a display, a speaker, one or more lightemitting diodes (LEDs), etc. Communication interface 360 may include anytransceiver-like mechanism that enables device 300 to communicate withother devices and/or systems via wireless communications (e.g., radiofrequency, infrared, and/or visual optics, etc.), wired communications(e.g., conductive wire, twisted pair cable, coaxial cable, transmissionline, fiber optic cable, and/or waveguide, etc.), or a combination ofwireless and wired communications. For example, communication interface360 may include mechanisms for communicating with another device orsystem via a network, such as network 140. In one alternativeimplementation, communication interface 360 may be a logical componentthat includes input and output ports, input and output systems, and/orother input and output components that facilitate the transmission ofdata to other devices.

As will be described in detail below, device 300 may perform certainoperations relating to video content ingestion. Device 300 may performthese operations in response to processor 320 executing softwareinstructions contained in a computer-readable medium, such as memory330. A computer-readable medium may be defined as a non-transitorymemory device. A memory device may include space within a singlephysical memory device or spread across multiple physical memorydevices. The software instructions may be read into memory 330 fromanother computer-readable medium or from another device. The softwareinstructions contained in memory 330 may cause processor 320 to performprocesses described herein. Alternatively, hardwired circuitry may beused in place of or in combination with software instructions toimplement processes described herein. Thus, implementations describedherein are not limited to any specific combination of hardware circuitryand software.

Mechanical module 410 may, for example, include a component that outputsa mechanical stimulation, such as, for example, a puff of fluid at apredetermined pressure, direction, quantity, velocity, duration, etc.The term fluid, as used herein, includes a gas, liquid, or any materialthe flows or behaves in a like manner (e.g., nitrogen, air, water, watervapor, etc.). The puff of fluid may be directed to one or both eyes ofthe subject or within proximity of the eye and/or eyelid (e.g., withinone-quarter inch, on-half inch, one inch, one and one-half inch, etc. ofthe eye, eyelid, eyelashes, etc.) to cause the subject to exhibit ablink reflex. Mechanical module 410 may also, or alternatively, includea component that applies a controlled mechanical pressure to theproximity of the eye and/or eyelid (e.g., a pin prick, a pinch, etc.).

Light module 420 may include a component (e.g., a light bulb, flashtube, a light emitting diode (LED), etc.) that outputs light (e.g., aflash of light, continuous light, a blinking light, etc.) at acontrolled and/or predetermined intensity level, power level, frequency,duration, etc. directed to one or both eyes of the subject to cause thesubject to exhibit a blink reflex.

Acoustic module 430 may include a component (e.g., a speaker, headphones, ear buds, etc.) that outputs an acoustic signal (e.g., a tone,white noise, rock music, etc.) at a controlled and/or predeterminedvolume, frequency, duration, etc. that causes the subject to exhibit ablink reflex.

Additionally, electrical module 440 may include a component (e.g.,electrodes, contacts, etc.) that outputs an electrical signal at apredetermined power level (e.g., current, voltage, etc.), frequency,duration, etc. that may be perceived by the subject as a small shock andwhich may cause the subject to exhibit a blink reflex. Stimulator 102may also, or alternatively, include a device capable of measuring thebrain activity of the subject before, during, or after the subject isstimulated by stimulator 102.

Confounder Module 450 include a device to confound or distract thesubject so as to attenuate a tendency by the subject to anticipatecertain stimuli provided by stimulator 102, which may affect theintegrity of the data. Confounder module 450 may include one or morelights can be turned on or off, one or more speakers that emit one or aseries of tones, a user interface displayed via a display device viawhich questions, objects, games, etc. are provided. For example, thesubject may interact with confounder module 450 by identifying whichlights turn on or off; by indicating whether an acoustic tone can beheard, whether the tone pitch is increasing, decreasing, or staying thesame; by answering questions and/or interacting with objects displayedvia the user interface, etc.

FIG. 6A is a diagram of an example eyelid tracking scheme 500(hereinafter, “tracking scheme 500”) associated with a subject. In anexample implementation, tracking scheme may be used by blink reflexdevice 100 to perform an operation to determine a blink reflex and/or ablink period of a subject by measuring, as a function of time, thelocation of all or a portion of one or both eyelids when the subjectinitiates a blink, performs the blink, and/or completes the blink. Asshown in FIG. 6A, tracking scheme 500 may include light source 510, acorneal reflection 515, a blink axis 520, an upper eyelid tracking point525, and a lower eyelid tracking point 530. Light source 510 may includea light bulb, an LED, a low power laser that does not cause damage tothe eye (e.g., less than approximately 5 milliwatts (mW), etc.) thatemits light that can be directed to an eye of the subject. Light source510 may also, or alternatively, be associated with stimulator 102 and/orsome other component of blink reflex device 100.

By way of example, light source 510 may emit a beam of light (e.g., asshown by the dotted line between light source 510 and the iris of theeye in FIG. 6A) in a manner that is incident on the cornea portion(e.g., a membrane that covers the iris and pupil portions of the eye) ofthe eye of a subject. The beam of light may enter the cornea and/or mayreflect off the cornea and/or iris portion of the eye to cause areflection of light to appear on a portion of the surface of the eye(e.g., shown by the “#” labeled corneal reflection 515). Sensor unit 215may detect corneal reflection 515 and may identify a first point alongan approximately vertical blink axis 520 (e.g., shown as the alternatingdashed and dotted vertical line labeled “blink axis 520”) at which theupper eyelid intersects blink axis 520 (e.g., shown as a “Δ” labeled“upper eyelid tracking point 525” in FIG. 6A). Additionally, oralternatively, sensor unit 215 may detect corneal reflection 515 and mayidentify a second point along blink axis 520 at which the lower eyelidintersects blink axis 520 (e.g., shown as an “A” labeled “lower eyelidtracking point 530” in FIG. 6A).

Additionally, or alternatively, sensor unit 215 may monitor and/or trackthe movement of the upper eyelid (e.g., before, during, and/or after thesubject blinks) based on the upper eyelid tracking point 525 and/or thelower eyelid tracking point 530. Sensor unit 215 may also, oralternatively, identify one or more different upper eyelid trackingpoints 525 associated with the upper eyelid (e.g., shown by the other“As” located on the upper eyelid of FIG. 6A) and may monitor and/ortrack the vertical position of one, some, or all of the different uppereyelid tracking points 525 (e.g., based on each individual verticalposition, a sum of the vertical positions, an average of the verticalpositions, etc. of the different upper eyelid tracking points 525).Sensor unit 215 may also, or alternatively, monitor and/or track thevertical position of one, some, or all of the different lower eyelidtracking points 530 in a manner similar to that described above.

Additionally, or alternatively, sensor unit 215 may track upper eyelidtracking points 525 and/or lower eyelid tracking points 530 in agenerally horizontal direction that is approximately orthogonal to blinkaxis 520. Additionally, or alternatively, sensor unit 215 may identify atracking point that enables the movement of the eye to be tracked, forexample, in the vertical direction, the horizontal direction, or someother direction. In this example, sensor unit 215 may track the changein location of corneal reflection 515 to determine eye movement.Additionally, or alternatively, sensor unit may identify some othertracking point, associated with the eye or portion thereof (e.g., anedge of the iris, the pupil, etc.).

FIG. 6B is a diagram of example stages 600 of a blink of an eye of asubject from which a blink reflex or blink period can be measured. Asshown in FIG. 6B, eye blink stages 600 may include a collection of eyeblink stages A through G associated with the blink of the eye of thesubject. The number of eye blink stages of FIG. 6B is provided forexplanatory purposes. In practice, there may be additional stages, fewerstages, or different stages than are shown in FIG. 6B. While stages 600is described in the context of upper eyelid tracking point 525,associated with the upper eyelid of the subject, additionally, oralternatively, stages 600 may be described in the context of one or moredifferent upper eyelid tracking points 525 and/or one or more lowereyelid tracking points 530 associated with the lower eyelid of thesubject.

Eye blink stage A may correspond to a first state of the eye of thesubject at a first time prior to the initiation of a blink. During eyeblink stage A, the eye may be open and/or the location of upper eyelidtracking point 525 may correspond to an initial position (e.g., shown asthe righting pointing arrow labeled “Initial Position” in FIG. 6B) onthe approximately vertical blink axis 520 with which upper eyelidtracking point 525 coincides. Eye blink stage B may correspond to asecond state of the eye at a second time after the initiation of a blinkwhen the upper eyelid and/or lower eyelid begins to close. During eyeblink stage B, the eye may begin closing and/or the location of uppereyelid tracking point 525 may correspond to a first position on thevertical axis that is located below the initial position on the verticalaxis. Eye blink stage C may correspond to a third state of the eye ofthe subject at a third time that occurs after the second time. Duringeye blink stage C, the eye may be continuing to close and/or thelocation of upper eyelid tracking point 525 may correspond to a secondposition on blink axis 520 that is located below the first position. Eyeblink stage D may correspond to a fourth state of the eye of the subjectat a fourth time that occurs after the third time. During eye blinkstage D, the eye may be closed and/or the location of upper eyelidtracking point 525 may correspond to a third position (e.g., shown asthe “closed position” in FIG. 6B) on blink axis 520 that is locatedbelow the second position. In implementations in which lower eyelidtracking point 530 (not shown in FIG. 6B) is being monitored and/ortracked by blink reflex device 100, upper eyelid tracking point 525 andlower eyelid tracking point may be located at approximately the sameposition on blink axis 520.

Eye blink stage E may correspond to a fifth state of the eye of thesubject at a fifth time that occurs after the fourth time. During eyeblink stage E, the eye may begin opening and/or the location of uppereyelid tracking point 525 may correspond to a fourth position on blinkaxis 520 that is located above the third position. Eye blink stage F maycorrespond to a sixth state of the eye of the subject at a sixth timethat occurs after the fifth time. During eye blink stage F, the eye maycontinue opening and/or the location of upper eyelid tracking point 525may correspond to a fifth position on blink axis 520 that is locatedabove the fourth position. Eye blink stage G may correspond to a sixthstate of the eye of the subject at a sixth time that occurs after thefifth time. During eye blink stage G, the eye may be open and/or thelocation of upper eyelid tracking point 525 may correspond to a sixthposition on blink axis 520 that is located above the fifth position.Additionally, or alternatively, the sixth position may coincideapproximately with the location of the initial position of eye blinkstage A. If this location is deemed significantly different than theinitial position of the eye, it may also be an additional indicator thatthere is altered brain function suggestive of brain injury by comparisonwith known prior baselines in the database for the subject.

FIG. 6C is a diagram of an example blink reflex response 650(hereinafter, “response 650”) associated with a blink reflex and blinkperiod of a subject. Response 650 may be measured and/or created byblink device 100 based on a blink reflex and/or blink period associatedwith an eye of a subject. As shown in FIG. 6C, response 650 may includea distance scale 655, a time scale 660, and a blink function 670(hereinafter, “blink function 670”). Distance scale 655 may include arange of distance (e.g., shown as the vertical axis labeled “VerticalDistance (mils)” ranging from −100 mils to +500 mils) that the uppereyelid tracking point 525, lower eyelid tracking point 530, or acombination of upper and lower eyelid tracking points 525 and 530,respectively, travel relative to an initial position on blink axis 520when the subject blinks. Time scale 655 may include a range of time(e.g., shown as the horizontal axis labeled “Time (milliseconds)”ranging from 0 to 675 ms or some other period of time) during which theeye of the subject blinks one or more times. Blink function 670 mayrepresent a relationship between a vertical distance that the eyelidtravels (e.g., upper eyelid tracking point 525, lower eyelid trackingpoint 530 or some combination thereof) as shown on distance scale 655 asa function of time on time scale 660 when the subject blinks. Thevertical dashed line labeled “Apply Stimulus” may identify a time (e.g.,based on time scale 655) at which stimulation is applied to the subject.

Blink reflex device 100 may measure the blink reflex of a subject andmay create blink function 670 based on the distance traveled by one orboth eyelids of the subject as a function of time. For example, blinkreflex device 100 may, in a manner similar to that described withrespect to FIG. 6C, begin to track an eyelid tracking point (e.g., uppereyelid tracking point 525, lower eyelid tracking point 530 and/or somecombination thereof) of the subject (e.g., at T=0 on time scale 660) andmay apply a stimulus to the subject (e.g., with a puff of fluid, amechanical, acoustic, electrical optical etc. stimulus). Blink reflexdevice 100 may track the movement of the eyelid tracking point and mayidentify a time at which eyelid tracking point begins to move verticallyrelative to blink axis 520 and/or a blink is initiated by the subject inresponse to the stimulus. Blink reflex device 100 may determine a timeperiod from the time when the stimulus is applied to when the eyelidtracking point begins to move or the blink is initiated (onset). Thetime period may correspond to the blink reflex (e.g., shown as T_(BR) inFIG. 6C).

Additionally, or alternatively, blink reflex device 100 may measure theblink period associated with the phases of the blink, the aggregatecurve referred to as the morphology of the blink. For example, when theeye of the subject is in the open state (e.g., stage A of FIG. 6B),blink reflex device 100 may determine that the eyelid (e.g., uppereyelid tracking point 525, lower eyelid tracking point 530, or somecombination thereof) is located at the initial position on distancescale 655 (e.g., approximately 0 mils) as shown by blink function 670(e.g., shown as prior to 75 ms on time scale 660). When the eye of thesubject is closing (e.g., stages B and C of FIG. 6B), blink reflexdevice 100 may determine that the tracking point of the eyelid haschanged to a different position relative to the initial position (e.g.,50, 100, 150, 250, 350, etc. mils on distance scale 655) as shown byblink function 670 (e.g., shown as between approximately 75 and 250 mson time scale 660). When the eye of the subject is in the closed state(e.g., stage D of FIG. 6B), blink reflex device 100 may determine thatthe eyelid tracking point is located a greatest distance from theinitial position on distance scale 655 (e.g., shown as approximately 400mils) as shown by blink function 670 (e.g., shown as betweenapproximately 251 and 275 ms on time scale 660).

Additionally, or alternatively, when the eye of the subject is opening(e.g., stages E and F of FIG. 6B), blink reflex device 100 may determinethat the tracking point of the eyelid has changed to a differentposition relative to the initial position (e.g., 50, 100, 150, 250, 350,etc. mils on distance scale 655) as shown by blink function 670 (e.g.,shown as between approximately 275 and 450 ms on time scale 660). Whenthe eye of the subject has returned to the open state (e.g., stage G ofFIG. 6B), blink reflex device 100 may determine that the eyelid (e.g.,upper eyelid tracking point 525, lower eyelid tracking point 530, orsome combination thereof) has returned to the approximate initialposition on distance scale 655 (e.g., approximately 0 mils) as shown byblink function 670 (e.g., shown as after 450 ms on time scale 660).

Blink reflex device 100 may determine a time period (the blink period orsometimes referred to as “blink duration”) for the eye lid to travelfrom the initial position, to the closed position and return to theinitial position (e.g., shown as T_(B) in FIG. 6C).

FIGS. 7A-7D are diagrams of example blink reflex devices 100 through 100that correspond to blink reflex device 100 associated with differentstimulator modules 410-440, respectively. As shown in FIGS. 7A-7D, eachof blink reflex devices 100-100 may include a housing 101 and one ormore components described above with respect to FIG. 3 includingprocessing unit 200, stimulator 102, and sensor 215. Housing 101 mayinclude a material of sufficient strength, structure, and/or rigidity toenable some or all of the components, described above with respect toFIG. 3 , to be attached and to operate in order to measure a blinkreflex associated with a subject. Housing 101 may also, oralternatively, have a shape that corresponds to a subject's face so asto securely cover one or both eyes of the subject (e.g., similar to ascuba mask, goggles, etc.), worn by the subject, or in which all or aportion of the head of the subject can be inserted in a manner thatenables stimulator 102 and/or sensor 215 sufficient line of sight to theeye or proximity thereof. While other components described with respectto FIG. 3 , including memory 210, user interface 220, communicationinterface 230 and transmit/receive 240, are not shown in FIGS. 7A-7D forsimplicity, in practice, blink reflex devices 100-100 may include one ormore such components of FIG. 3 , and/or additional components, fewercomponents, different components or differently arranged components thanare described with respect to FIGS. 7A-7D.

As shown in FIG. 7A, blink reflex device 100 may include housing 101,stimulator 102, sensor 215, processing unit 200 and one or more othercomponents described above with respect to FIG. 3 (not shown in FIG.7A). Stimulator 102 may include one or more mechanical modules 410. Asshown in FIG. 7A, stimulator 102 may include a pair of mechanicalmodules 410-1 and 410-2. Mechanical module 410-1 may be associated withthe right eye of the subject and mechanical module 410-2 may beassociated with the left eye of the subject. One or both mechanicalmodules 410 may output a puff of fluid (e.g., air, nitrogen, water,water vapor, etc.) in the direction of one or both eyes of the subject.The puff of fluid may make contact with one or both eyes of the subjectunder sufficient velocity and/or pressure in a manner that causes ablink reflex in the subject that can be detected and measured by sensor215 in a manner similar to that described above with respect to FIGS. 5,6A and 6B (e.g., by tracking the movement of upper eyelid tracking point525 and/or lower eyelid tracking point 530 (not shown in FIG. 7A)).Mechanical module 410 may also, or alternatively, be installed in and/orattached to housing 101. Additionally, or alternatively, mechanicalmodule 410 may output the puff of air based on an instruction receivedfrom processing unit 200 and/or may output a signal to processing unit200 indicating that the puff of air has been output by mechanical module410.

As shown in FIG. 7B, blink reflex device 100 may include some or all ofthe components described with respect to FIG. 7A. Stimulator 102 mayinclude one or more optical modules 420 (e.g., optical modules 420-1 forthe right eye and 420-2 for the left eye). One or both optical modules420 may output one or more beams of light that shines in the directionof one or both eyes of the subject. The light may be of sufficientbrightness and intensity to causes a blink reflex to occur in thesubject, which can be detected and measured by sensor 215 in a mannersimilar to that described above with respect to FIGS. 5, 6A and 6B.Optical module 410 may also, or alternatively, be installed in and/orattached to housing 101. Additionally, or alternatively, optical module420 may output the beam of bright light based on an instruction receivedfrom processing unit 200 and/or may output a signal to processing unit200 indicating that the beam of bright light has been output by opticalmodule 420.

As shown in FIG. 7C, blink reflex device 100 may include some or all ofthe components described with respect to FIGS. 7A and/or 7B. Stimulator102 may include one or more acoustic modules 430, such as, for example,a set of head phones, one or more ear buds, one or more speakers, etc.As shown in FIG. 7C, acoustic module 430 includes a set of headphonesthat are worn by the subject. Acoustic module 430 may output one or moreacoustic tones, noise (e.g., white noise, pink noise, etc.), music(e.g., rock music, heavy metal, etc.), etc. (hereinafter, the “acousticsignal”) into one or both ears of the subject. The acoustic signal maybe of sufficient volume and frequency to be heard by the subject and tocauses a blink reflex to occur in the subject, which can be detected andmeasured by sensor 215 in a manner similar to that described above withrespect to FIGS. 5, 6A and 6B. Acoustic module 430 may also, oralternatively, be installed in and/or attached to housing 101.Additionally, or alternatively, acoustic module 430 may output theacoustic signal based on an instruction received from processing unit200 and/or may output a signal to processing unit 200 indicating thatthe acoustic signal has been output by acoustic module 430.

As shown in FIG. 7D, blink reflex device 100 may include some or all ofthe components described with respect to FIGS. 7A-7C. Stimulator 102 mayinclude one or more electrical modules 440 (e.g., electrical modules440-1 for the right eye and 440-2 for the left eye). One or both opticalmodules 440 may output one or more electrical signals in the proximityof one or both eyes of the subject (e.g., within ¼ inch, ½ inch, 1 inch,1½ inches, 2 inches, etc.). The electrical signal may be of sufficientpower, signal strength, voltage, current, etc. to cause a blink reflexto occur in the subject, which can be detected and measured by sensor215 in a manner similar to that described above with respect to FIGS. 5,6A and 6B. Electrical module 440 may also, or alternatively, beinstalled in and/or attached to housing 101. Additionally, oralternatively, electrical module 440 may output the electrical signalbased on an instruction received from processing unit 200 and/or mayoutput a signal to processing unit 200 indicating that the electricalsignal has been output by electrical module 440.

FIGS. 8A-8D are diagrams of different types of example blink reflexresponses 800-875, respectively, associated with a subject. Blink reflexresponses 800-875 may be obtained, measured and/or generated by blinkreflex device 100 and/or blink reflex devices 100-100 based on a blinkreflex of a subject. As shown in FIGS. 8A-8D, blink reflex responses800-875, respectively, may each include distance scale 655 and timescale 660 as described above with respect to FIG. 6C. Blink reflexresponses 800-875 are shown in FIGS. 8A-8D, respectively, ascorresponding to a single blink of the eye that occurs during aparticular time period, for simplicity. In practice, blink reflexresponses 800-875 may correspond to two or more blinks of the eye thatoccur over an extended period of time that is greater than that theparticular time period.

As shown in FIG. 8A, blink reflex response 800 (hereinafter “response800”) may include a first blink function 815 associated with the righteye and a second blink function 820 associated with the left eye. Firstblink functions 815 and second blink function 820 may, in a mannersimilar to that described above with respect to FIG. 6C, represent ablink reflex of the right eye and left eye of the subject, respectively,obtained by blink reflex device 100. Blink reflex device 100 maydetermine a first time period, associated with first blink function 815that corresponds to a first blink reflex of the right eye (e.g.,T_(BR(1))). Blink reflex device 100 may determine a second time period,associated with second blink function 820 that corresponds to a secondblink reflex of the left eye (e.g., T_(BR(2))).

Additionally, or alternatively, blink reflex device 100 may applystimulus (e.g., mechanical, optical, acoustic, electrical, etc.) to oneeye and/or the proximity thereof (e.g., the right eye in our case) andmay obtain a first blink reflex from the right eye (e.g., T_(BR(1))) anda first blink reflex of the left eye (e.g., T_(BR(2))) in response tothe stimulus to the right eye. The right eye to which the stimulus isapplied may sometimes be referred to herein as the “stimulated eye” orthe “ipsilateral eye.” The left eye, that did not receive the stimulus,may sometimes be referred to herein as the “non-stimulated eye” or the“contralateral eye.” In such a case, there may be a period of delaybetween the initiation of the blink reflex of the ipsilateral eyerelative to the other, contralateral eye. The period of delay maycorrespond to the difference in blink reflex between the ipsilateral eyeand contralateral eye (e.g., T_(BR(1))<T_(BR(2))). Such a difference inblink reflex, between the ipsilateral eye and the contralateral eye, maybe due to the additional neural pathways and/or distance that electricalbrain signals must travel to trigger the blink reflex in thenon-stimulated, contralateral eye (e.g., the left eye in our case). Inthe event that the difference in blink reflex between the ipsilateraleye and contralateral eye (e.g., ΔT_(BR)=|T_(BR(1))−T_(BR(2))|) changesby more than a first threshold (e.g., after a traumatic event to thehead or spine of the subject), such neural pathways may have beeneffected or impaired by the trauma or some neurological functionalimpairment.

Additionally, or alternatively, despite the larger blink reflex of thenon-stimulated eye (e.g., the left eye), the first blink period of thenon-stimulated eye (e.g., T_(B(2))) may be less than the first blinkperiod of the stimulated right eye (e.g., T_(B(2))<T_(B(1)), whereT_(B(1)) is the first blink period of the right eye). In the event thatthe difference in blink period between the ipsilateral eye andcontralateral eye (e.g., ΔT_(B)=|T_(B(1))−T_(B(2))|) changes by morethan a second threshold (e.g., after a traumatic event to the head orspine of the subject), such neural pathways may have been effected orimpaired by the trauma or some neurological functional impairment.

If, however, blink reflex device 100 applies stimuli to both eyes (e.g.,either sequentially or at approximately the same time), the differencebetween the right eye blink reflex or blink period and the left eyeblink reflex or blink period, respectively, may be an indication of abrain injury and/or a degenerative neurological condition associatedwith one or both sides of the brain and/or one or more neural pathwaysof the brain through which electrical brain signals that trigger theblink reflex travel.

As shown in FIG. 8B, blink reflex response 825 (hereinafter “response825”) may include a third blink function 830 and a fourth blink function840. Third blink function 830 may, in a manner similar to that describedabove with respect to FIGS. 6B and 8A, represent a third blink reflex ofan eye of the subject obtained, by blink reflex device 100, at a thirdpoint in time before the subject suffered from trauma or was known notto be suffering from a brain injury or degenerative neurologicaldisorder) (sometimes referred to herein after “baseline blink reflex”).Additionally, or alternatively, third blink function 830 may represent acombination of third blink reflex functions (e.g., an average, a mean, amedian, a weighted average, etc.) associated with one or more othersubjects that are known not to suffer from a brain injury ordegenerative neurological disorder. Such other subjects may, forexample, be associated with one or more similar demographic parametersrelative to the subject (e.g., similar age group, gender, race, etc.).Fourth blink function 840 may correspond to a fourth blink reflex of theeye obtained, by blink reflex device 100, at a fourth point in time thatoccurs at a current time and/or within a short time period after thesubject is known to have suffered from trauma (e.g., within 5 minutes,10 minutes, 30 minutes, 1 hour, 2 hours, 5 hours, 12 hours, 24 hours,etc.). Blink reflex device 100 may, based on third blink function 830,determine a third blink reflex of the eye (e.g., T_(BR(3))) and/or,based on fourth blink function 840, determine a fourth blink reflex ofthe eye (e.g., T_(BR (4))). In the event that the difference in baselineblink reflex and the post-trauma blink reflex (e.g.,ΔT_(BR)=|T_(BR(3))−T_(BR(4))|) changes by more than a third threshold, apotential brain injury or degenerative neurological condition may existswithin the subject. Similarly, in the event that the difference betweenbaseline blink period and the post-trauma blink period (e.g., (e.g.,ΔT_(B)=T_(BR(3))−T_(BR(4))|) is greater than a fourth threshold, apotential brain injury or degenerative neurological condition may existswithin the subject.

As shown in FIG. 8C, blink reflex response 860 (hereinafter “response860”) may include a fifth blink function 860 and a sixth blink function870. Fifth blink function 860 may identify a fifth blink reflex and/orfifth blink period of an eye (e.g., the right or left eye) of thesubject obtained without confounding the subject prior to and/or whileapplying stimuli to the subject. Sixth blink function 870 may identify asixth blink reflex and/or a sixth blink period of the eye (e.g., theright or left eye) based on confounding the subject prior to and/orwhile applying the stimuli to the subject. As shown with respect tofifth blink function 860, blink reflex device 100 may determine thefifth blink reflex (e.g. T_(BR(5))) and/or the fifth blink period (e.g.,T_(B(5))) of the eye without confounding. As shown with respect to sixthblink function 870, blink reflex device 100 may determine the sixthblink reflex (e.g., T_(BR(6))) and/or the sixth blink period (e.g.,T_(B(6))) of the eye with confounding. Blink reflex device 100 may, in amanner to be described later, use differences between the fifth andsixth blink reflexes with and without confounding and/or differences inthe fifth and sixth blink periods with and without confounding todetermine whether a potential brain injury or degenerative neurologicalcondition exists within the subject.

As shown in FIG. 8D, blink reflex response 875 (hereinafter “response875”) may include a seventh blink function 880, an eighth blink function885, and a ninth blink function 890 obtained and/or created by blinkreflex device 100. Seventh blink function 880 may identify a seventhblink reflex (e.g., T_(BR(7))) and a seventh blink period (e.g.,T_(B(7))) of the eye of the subject (e.g., right or left eye) withoutproviding any stimuli to the subject. Eighth blink function 885 mayidentify an eighth blink reflex (e.g., T_(BR(8))) and an eighth blinkperiod (e.g., T_(B(8))) of the eye based on providing a first type ofstimuli (e.g., mechanical, optical, acoustic, electrical, etc. stimuli)to the eye or proximity thereof of the subject. Ninth blink function 890may identify a ninth blink reflex (e.g., T_(BR(9))) and a ninth blinkperiod (e.g., T_(B(9))) of the eye based on applying a second, differenttype of stimuli to the subject. Blink reflex device 100 may, in a mannerto be described below, use the differences in one or more of these blinkreflex and between these blink periods to determine whether a potentialbrain injury or degenerative neurological condition exists within thesubject.

FIG. 9 is a diagram of an example blink reflex response 900(hereinafter, “response 900”), associated with a subject that includesdata to be removed and/or filtered from response 900. As shown in FIG. 9, response 900 may be created by blink reflex device 100 and/or blinkreflex devices 100-100, based on multiple blinks of a right eye of asubject, associated with blink function 905 and multiple blinks of aleft eye of the subject associated with blink function 910. In a mannersimilar to that described above with respect to FIGS. 8A-8D, a normalblink of the right and/or left eye may correspond to approximatelysymmetric peaks in portions of blink responses 905 and/or 910 (e.g., asshown by ellipses 920). Such peaks may correspond to a normal blinkreflex in response to stimulus being provided to the subject and/or anormal blink period based on stages A through G (FIG. 6B) in which theeye begins in the open state (e.g., stage A in which the eyelids are inan initial position), transitions to the closed state (e.g., stage D)and returns to the open state (e.g., stage G in which the eyelids returnto approximately the initial position of stage A). Additionally, blinkresponses 905 and/or 910 may include a normal blink reflex and/or blinkperiod that is voluntary or spontaneous that is not in response to anystimulus being provided to the subject (e.g., as shown by ellipse 922).

Additionally, or alternatively, blink reflex device 100 may detect ablink that is not a normal blink (sometimes referred to as a “doubleblink”) in which one or both eyes transition from the open state to theclose state and begin returning to the open state, but reverse directionand begin closing and/or returning to the closed state prior to reachingthe open state (e.g., as shown by ellipse 925). Additionally, oralternatively, blink reflex device 100 may detect a blink that is not anormal blink (sometimes referred to as a “micro-sleep”) in which one orboth eyes transition from the open state to the close state and beginreturning to the open state at rate that is substantially slower thanthat associated with a normal blink. Such a double blink and/ormicro-sleep event may be an indication that the subject is experiencingfatigue and/or may occur over a prolonged period that is substantiallylonger than the normal blink reflex (e.g., 5 times longer, 10 timeslonger, 20 times longer). Such data could be used, by blink reflexdevice 100 to identify potential impairments in cognitive alertness ofthe subject and/or to determine whether a potential brain injury ordegenerative neurological condition exists within the subject.Additionally, or alternatively, for determining a blink reflex and/orblink period, data associated with a double blink and/or micro-sleepevent may introduce errors into the determination of the period of timeduring which a blink reflex occurs. Blink reflex device 100 may reject,discard, or ignore such data when determining the blink reflex and/orblink period.

FIG. 10 is a flowchart of an example process 1000 for determiningwhether a subject suffers from brain injury or a degenerativeneurological condition. Process 1000 may be performed by one or moredevices associated with blink reflex device 100 and/or 100-100.Additionally, or alternatively, some or all of process 1000 may beperformed by a device, or collection of devices separate from, or incombination with blink reflex device 100 and/or 100-100. FIG. 11 is adiagram of an example data structure 1100 that may store informationassociated with a blink reflex of a subject. FIG. 12 is a diagram of anexample data structure 1200 that stores information associated with achange in blink reflex of a subject. Process 1000 of FIG. 10 will bedescribed with references to all or a portion of data structure 1100 ofFIG. 11 and data structure 1200 of FIG. 12 .

In the description below, assume that a subject has been subject to atraumatic event, such as, for example, a blow to the head that a playerin an athletic event might experience during a game (e.g., a footballplayer, soccer player, lacrosse player, etc.), a driver of a car mightexperience during an accident, etc. Assume further that a user (e.g., acoach, a paramedic, a nurse, etc.), associated with blink reflex device100, places blink reflex device 100 on the subject in a manner thatenables blink reflex device 100 to obtain (e.g., detect, measure,record, etc.) a blink reflex response associated with the subject.

As shown in FIG. 10 , process 1000 may include receiving a request toperform a test on a subject (block 1005) and detect an eye of thesubject based on the request (block 1010). For example, blink reflexdevice 100 may receive an instruction to obtain a blink reflex responsefrom the subject, such as when the user selects a particular button(e.g., to power up blink reflex device 100, etc.) on blink reflex device100 and/or when blink reflex device 100 is placed on the subject, etc.).Blink reflex device 100 (e.g., sensor unit 215) may, based on receivingthe instruction, may detect one or both eyes of the subject. Forexample, blink reflex device 100 may receive information associated withthe eye of the subject (e.g., the face, one or both eyes, one or moreeyelids, an area around an eye, etc. of the subject) and may determinewhether the received information matches stored information (e.g., avisual signature of a standard eye stored in memory 210) associated aparticular eye, such as a video and/or image of a standard eye, eyelid,proximity thereof. In the event that the received information matchesthe stored information, blink reflex device 100 may use one or moreknown techniques to create a corneal reflection (e.g., cornealreflection 515 of FIG. 6A) on and/or within the eye to identify one ormore tracking points associated with the subject (e.g., upper eyelidtracking point 525 (FIG. 6A), lower eye tracking point 530 (FIG. 6A),and/or some combination of upper and/or lower eyelid tracking points).Blink reflex device 100 may also, or alternatively, identify an initiallocation of the upper eyelid (e.g., based on upper eyelid tracking point525) and/or the lower eyelid (e.g., based on lower eyelid tracking point530) when the eye is in the open state. Blink reflex device 100 mayoutput a notification that a tracking point has been identified. In theevent that the received information does not match the storedinformation, blink reflex may output a notification that alerts the userthat a tracking point cannot be identified.

As also shown in FIG. 10 , process 1000 may include identifying a typeof stimuli to apply to the subject (block 1015). For example, blinkreflex device 100 may, based on identifying a tracking point associatedwith the eye, determine a type of stimuli that is to be used to obtain ablink reflex response from the subject. Blink reflex device 100 may, forexample, receive an indication from the user that identifies the type ofstimuli when the user selects a particular button on blink reflex device100 (e.g., a button identifying mechanical, optical, acoustic, and/orelectrical stimuli). Additionally, or alternatively, a particular typeof stimuli, such as, for example, a mechanical stimuli (e.g., a puff offluid, a pin prick, etc.) may be pre-programmed (e.g., as a defaultstimuli) into blink reflex device 100 by the user or duringmanufacturing. Blink reflex device 100 may also, or alternatively,receive an indication from the user (e.g., by selecting a specificbutton, preprogramming by user, preprogramming during manufacture, etc.)whether stimuli is to be provided to the right eye and/or proximitythereof, the left eye and/or proximity thereof, and/or both eyes and/orproximities thereof.

Additionally, or alternatively, the user may indicate whether aconfounding operation is to be performed on the subject by selecting acertain button on blink reflex device 100. Blink reflex device 100 mayinclude a default mode (e.g., preprogrammed by the user and/or duringmanufacturing) that does not include a confounding operation.

As further shown in FIG. 10 , if the type of stimuli indicates aconfounding operation (block 1020—YES), process 1000 may includeperforming a confounding operation on the subject (block 1025). Forexample, blink reflex device 100 may determine that a confoundingoperation is to be performed and may (e.g., using stimulator 102,confounder module 450, etc.) perform a confounding operation on thesubject. The confounding operation may cause the subject respond toquestions, audible sounds, a flash of light, etc. for the purpose ofdistracting the subject, which may preclude the subject fromanticipating the stimuli and/or avoiding the surprise of the stimuli.Being surprised and/or startled by the stimuli may cause the subject toblink as a reflex in response to the stimuli rather than in anticipationof such stimuli, which may lead to inaccurate results. For example,blink reflex device 100 may perform the confounding operation byintermittently displaying one or more lights in the field of view of thesubject and blink reflex device 100 and/or the user may direct thesubject to identify when one of the lights is lit and/or the position ofeach light within the field of view. The confounding operation may causethe subject to focus concentration on one or more of the intermittentlights, which may preclude the subject from anticipating the stimuli.Additionally, or alternatively, blink reflex device 100 may also, oralternatively, perform the confounding operation using one or moresounds in which blink reflex device 100 and/or the user directs thesubject to identify when a sound is made, which ear the sound isdirected, whether the pitch is increasing or decreasing, etc. Blinkreflex device 100 may also, or alternatively, perform other confoundingoperations (e.g., mechanical, electrical, etc.) by causing, for example,the subject to interact with a user interface displayed on user device110 and/or blink reflex device 100 by answering questions, pointing tomoving targets, etc.

As yet further shown in FIG. 10 , if the type of stimuli does notindicate a confounding operation (block 1020—NO) or while performing theconfounding operation on the subject (block 1025), process 1000 mayinclude providing to the subject the stimuli based on the identifiedtype of stimuli (block 1030). For example, blink reflex device 100 maydetermine that the identified type of stimuli indicates that aconfounding operation is not to be performed on the subject. Blinkreflex device 100 may, based on the determination that the confoundingoperation is not to be performed, provide the stimuli to the subjectwithout performing the confounding operation. Alternatively, blinkreflex device 100 may, while performing the confounding operation in amanner described above with respect to block 1025, provide stimuli tothe subject while the confounding operation is being performed.

For example, blink reflex device 100 may provide a stimulus to thesubject to cause the subject to reflexively blink in a manner that canbe detected, monitored and/or recorded by blink reflex device 100.Additionally, or alternatively, blink reflex device 100 may stimulatethe subject based on the identified type of stimuli. For example, if thetype of stimuli corresponds to a mechanical stimulation, blink reflexdevice 100 (e.g., stimulator 102, mechanical module 410, etc.) may causea puff of fluid (e.g., air, nitrogen, water, water vapor, etc.) to bedirected and/or targeted to the selected eye of the subject (e.g.,selected by the user and/or based on preprogramming). The puff of fluidmay be associated with a particular volume, direction, pressure,velocity, acceleration, force, etc. that causes the subject to bestartled or surprised. Additionally, or alternatively, if the type ofstimuli corresponds to an optical stimulation, blink reflex device 100(e.g., stimulator 102, light module 420, etc.) may cause a beam of lightto be shined in the selected eye of the subject. The beam of light maybe associated with a particular intensity, power, frequency, beam width,etc. that causes the subject to be startled or surprised.

Additionally, or alternatively, if the type of stimuli corresponds to anacoustic stimulation, blink reflex device 100 (e.g., stimulator 102,acoustic module 430, etc.) may cause a sound (e.g., a loud tone, music,etc.) to be directed into an ear, of the subject, that corresponds tothe same side of the subject as the selected eye of the subject. Thesound may be associated with a volume level, power level, frequencyrange, directivity, etc. that causes the subject to be startled orsurprised. Additionally, or alternatively, if the type of stimulicorresponds to an electrical stimulation, blink reflex device 100 (e.g.,stimulator 102, electrical module 420, etc.) may cause a beam of lightto be shined in the selected eye of the subject. The beam of light maybe associated with a particular intensity, power, frequency, beam width,etc. that causes the subject to be startled or surprised.

As also shown in FIG. 10 , process 1000 may include obtaining firstblink reflex information from the subject (block 1035) and obtainingsecond blink reflex information from the subject (block 1040). Forexample, blink reflex device 100 may, at a first time, track the mannerin which the subject reflexively blinks as a result of providing thestimuli to the subject. The first time (e.g., T1) may correspond to atime during or after which the subject experiences a traumatic eventassociated with a blow or impact to the head. Blink reflex device 100may track and/or record, as a function of time, the location along blinkaxis 520 (FIG. 6A) of one or more upper eyelid tracking points 525,lower eyelid tracking points 530 and/or some other tracking pointsrelative to the initial location of such tracking points (e.g., when theeye is in the open state) to obtain information associated with thefirst blink reflex of the subject (sometimes referred to a “blinkfunction”) in a manner similar to that described above with respect toFIGS. 6B and 8A-8D. Additionally, or alternatively, blink reflex device100 may identify certain abnormal blink functions, such as a micro-blinkand/or double-blink in a manner similar to that described above withrespect to FIG. 9 and may discard, ignore, or erase a portion of theinformation associated with the first blink reflex to which the abnormalblink corresponds. Additionally, or alternatively, blink reflex device100 may determine whether the subject potentially suffers from fatigue,cognitive impairment and/or impaired neurological function based on theinformation associated with the abnormal blink functions.

Additionally, or alternatively, blink reflex device 100 may obtaininformation associated with the blink of the subject when stimuli hasnot been provided to the subject, such as when the subject intentionallyblinks (e.g., in response to a command from the user) and/or when thesubject naturally blinks to lubricate the surface of the eye. Blinkreflex device 100 may also, or alternatively, store the information,associated with the first blink reflex and/or first blink period, in adata structure (e.g., data structure 1100 of FIG. 11 to be describedbelow) within a memory associated with blink reflex device 100 (e.g.,memory 210) and/or may transmit the information, associated with firstblink reflex and/or first blink period, to server 120 and/or database130 for storage in a data structure.

Additionally, blink reflex device 100 may retrieve from a memory (e.g.,memory 210), database 130 and/or server 120, information associated witha second blink reflex obtained at a prior, second point in time (e.g.,T2). The information associated with the second blink reflex may havebeen obtained from the subject at the second time before the subjectexperienced the traumatic event and/or when the subject is known not tobe suffering from a neurological condition. Additionally, oralternatively, the information, associated with the second blink reflexand/or second blink period, may correspond to a combination of one ormore blink functions (e.g., an average, mean, median, etc.) of one ormore other subjects (e.g., of the same or similar demographics, such asage, race, gender, etc. relative to the subject) at the second time whenthe other subjects are known not to be suffering from a neurologicalcondition.

For example, as shown in FIG. 11 , data structure 1100 may storeinformation associated with the blink reflex of a subject and/or othersubjects and may include a collection of fields, such as a subject infofield 1105, a stimuli type field 1110, a confound field 1115, an eyeidentifier field 1120, a baseline time field 1100, a baseline blinkreflex field 1130, a time field 1135, and a blink reflex field 1140.Additionally, or alternatively, data structure 1100 may be stored byblink reflex device 100 (e.g., memory 210), server 120, and/or database130. The number of fields illustrated in FIG. 11 , is provided forexplanatory purposes only. In practice, there may be additional fields;fewer fields; different fields; or differently arranged fields thanillustrated in FIG. 11 .

Fields 1105 through 1130 may, for example, correspond to informationpreviously obtained from the subject or other subjects prior to atraumatic event experienced by the subject. The other subjects may beassociated with similar parameters or demographics as the subject (e.g.,similar age, race, gender, size, weight, etc.). Fields 1135 and 114 maycorrespond to information obtained from the subject after the traumaticevent is experienced by the subject. Subject info field 1105 may storeinformation associated with a subject from which information associatedwith the first blink reflex and/or second blink reflex is obtained. Forexample, information, associated with the subject, may identify a nameof the subject, an address of the subject, demographic informationassociated with the subject (e.g., age, gender, race, etc.), priorhistory (e.g., prior incidences of brain injury, neurologicalimpairment, etc.), a unique identifier associated with the subject(e.g., a number, string, all or a portion of a social security number,etc.), etc. Subject info field 1105 may also, or alternatively, storeinformation associated with one or more other subjects, known not to besuffering from a neurological condition, from which respectiveinformation, associated with a second blink reflex, is obtained.Additionally, or alternatively, the demographic information, associatedwith the other subjects, may be the same or similar to that of thesubject.

Stimuli type field 1110 may store information that identifies a type ofstimuli used to obtain the information associated with the first blinkreflex or the second blink reflex. For example, the information thatidentifies the type of stimuli may identify if no stimuli was used(e.g., shown as S0 within stimuli type field 1110 of FIG. 11 ) orwhether mechanical stimuli (e.g., shown as S1 within stimuli type field1110 of FIG. 11 ), light stimuli (e.g., shown as S2 within stimuli typefield 1110 of FIG. 11 ), acoustic stimuli (e.g., shown as S3 withinstimuli type field 1110 of FIG. 11 ), and/or electrical stimuli (e.g.,shown as S4 within stimuli type field 1110 of FIG. 11 ) was used toobtain the information associated with the first blink reflex and/orsecond blink reflex. Stimuli type field 1110 may also, or alternatively,store information that identifies whether the stimuli is provided to theleft eye, right eye, both eyes or proximity thereof of the subject.

Confound field 1115 may store information that identifies whether aconfounding operation was performed on the subject to obtain theinformation associated with the first blink reflex or the second blinkreflex (e.g., shown as C0 in field 1115 of FIG. 11 if a confoundingoperation was not performed, and C1 if a confounding operation wasperformed). Eye identifier field 1120 may store information thatidentifies whether the information associated with the first blinkreflex or second blink reflex was obtained from the subject with respectto the left eye (e.g., shown as L within stimuli type field 1120 of FIG.11 ), right eye (e.g., shown as R within stimuli type field 1120 of FIG.11 ) or both eyes (e.g., shown as B within stimuli type field 1120 ofFIG. 11 ). Baseline time field 1100 may store information (e.g., a date,time, etc.) that identifies a previous time (e.g., identified above asthe second time and shown as T2 within baseline time field 1100 of FIG.11 ) at which a blink reflex operation was performed (e.g., by blinkreflex device 100) to obtain the information associated with the secondblink reflex or second blink period of the subject or one or more othersubject (e.g., other subjects associated with the same or similardemographics as the subject). The previous time may, for example,correspond to a time before the subject experienced a traumatic eventand/or when it is known that the subject or the other subjects are knownnot to be suffering from a neurological condition. Baseline blink reflexfield 1130 may store information associated with the second blink reflexand/or second blink period. The information associated with the secondblink reflex and/or second blink period may, in a manner similar to thatdescribed above with respect to FIGS. 6B and 8A-8D, correspond to ablink function of the subject.

Time field 1135 may store information (e.g., a date, time, etc.) thatidentifies a time (e.g., identified above as the first time or a currenttime and shown as T1 in time field 1135 of FIG. 11 ) at which a blinkreflex operation was performed (e.g., by blink reflex device 100) toobtain the information associated with the first blink reflex and/orfirst blink period of the subject. The time may, for example, correspondto a particular time during or after which the subject experiences atraumatic event and/or when it is known that the subject is sufferingfrom a neurological condition. Blink reflex field 1140 may storeinformation associated with the first blink reflex and/or the firstblink period of the subject. The information associated with the firstblink reflex and/or first blink period may, in a manner similar to thatdescribed above with respect to FIGS. 6B and 8A-8D, correspond to ablink function of the subject that identifies a vertical distance thatone or more eyelids, of the subject, move during one or more blinks bythe subject as a function of time during which the one or more blinksare measured.

By way of an example associated with dashed ellipse 1152 of FIG. 11 , atthe second time (e.g., T2), blink reflex device 100 may have previouslyobtained information associated with the second blink reflex and/orsecond blink response of the subject without stimuli to the subject(e.g., S0), without performing a confounding operation (e.g., NC),and/or from both eyes of the subject (e.g., B) and may store suchinformation in data structure 1100 (e.g., shown as BTB0).

Additionally, or alternatively, at the first time (e.g., T1) that occursafter the second time (e.g., T2) and after the subject has experienced atraumatic event or is known to suffer from a degenerative neurologicalcondition, blink reflex device 100 may obtain information associatedwith the first blink reflex and/or first blink period of the subjectunder the same conditions as described in the previous paragraph. Blinkreflex device 100 may store such information in data structure 1100(e.g., shown as BT0).

Additionally, or alternatively, as shown with respect to dashed ellipse1154 of FIG. 11 , information associated with the second blink reflexand/or second blink period of the subject, may have been previouslyobtained at the second time (e.g., T2) under the same conditions asthose described above, except in this case the subject was beingconfounded by blink reflex device 100 (e.g., shown as C in confoundfield 1115). Blink reflex device 100 may, in this example, store theinformation associated with second blink reflex in data structure 1100(e.g., shown as BTB1). Blink reflex device 100 may, during the firsttime (e.g., T1), obtain information associated with the first blinkreflex and/or the first blink period under the confounding conditionsdescribed in this example, and may store such information in datastructure 1100 (e.g., shown as BT1).

Additionally, or alternatively, as shown with respect to dashed ellipse1156 of FIG. 11 , at the second time (e.g., T2), blink reflex device 100may have previously obtained information associated with the secondblink reflex and/or second blink period in one or more separatemeasurements of the right eye (e.g., shown as R) and of the left eye ofthe subject (e.g., shown as L), by providing a first stimuli to thesubject (e.g., a mechanical stimuli shown as S1), and performing aconfounding operation on the subject (e.g., shown as C). Blink reflexdevice 100 and may store such information in data structure 1100 (e.g.,shown as RTB1 for the right eye and LBT1 for the left eye).Additionally, or alternatively, at the first time (e.g., T1) that occursafter the second time and after the subject has experienced a traumaticevent or is known to suffer from a degenerative neurological condition,blink reflex device 100 may obtain information associated with the firstblink reflex and/or first blink period of the subject (e.g., for theright eye and separately for the left eye) under the same conditions asdescribed immediately above and may store such information in datastructure 1100 (e.g., shown as RT1 for the right eye and LT1 for theleft eye).

Additionally, or alternatively, as shown with respect to dashed ellipse1158, blink reflex device 100 may, at the second time (e.g., T2), havepreviously obtained information associated with second blink reflexand/or second blink period from the right and/or left eye based on theconditions set forth in the previous example with respect to dashedellipse 1156, except that no confounding operation is performed (e.g.,NC). Blink reflex device 100 may store such information in datastructure 1100 (e.g., shown as RTB2 for the right eye and LTB2 for theleft eye). Additionally, or alternatively, blink reflex device 100 may,at the first time (e.g., T1), obtain information associated with thefirst blink reflex and/or first blink period of the subject under thesame conditions as described immediately above and may store suchinformation in data structure 1100 (e.g., shown as RT2 for the right eyeand LT2 for the left eye). Blink reflex may also, or alternatively, havepreviously obtained (e.g., at T1) and/or may obtain (e.g., at T2) otherinformation associated with the first blink reflex/first blink period orthe second blink reflex/second blink period based on other types ofstimuli (e.g., shown as S2, S3, S4, etc.) and may store such informationin data structure 1100 (e.g., as shown by dashed rectangle 1160 of FIG.1100 ).

Returning to FIG. 10 , process 1000 may include determining a change inthe blink reflex based on the first blink reflex information and thesecond blink reflex information (block 1045). For example, blink reflexdevice 100 (e.g., processing unit 200) may compare the informationassociated with the first blink reflex and/or first blink period of thesubject with the information associated with the second blink reflexand/or second blink period. The information may be associated with thesecond blink reflex or second blink period may have been obtained fromthe subject and/or one or more other subjects. In the latter case, theinformation associated with the second blink reflex and/or second blinkperiod may be based on a combination of information taken from one ormore second blink reflexes and/or second blink periods of one or moreother subjects (e.g., based on an average, mean, median, etc.), obtainedunder the same and/or similar conditions (e.g., type of stimuli, with orwithout confounding, etc.). Blink reflex device 100 may identify anamount of difference or change between the information associated withthe first blink reflex and/or blink period and the informationassociated with the second blink reflex and/or blink period. Forexample, blink reflex device 100 may, with respect to conditions inwhich the subject is not stimulated or confounded, compare theinformation associated with the first blink reflex or blink period ofthe subject (e.g., BT0 in the case of both eyes being measured) with theinformation associated with the second blink reflex and/or blink period(e.g., BTB0), to identify an amount of change or difference in the blinkreflex and/or blink period under such conditions (e.g., ΔB0=|BT0−BTB0|).Additionally, or alternatively, blink reflex device 100 may, withrespect to conditions in which the subject is not stimulated but isconfounded, compare the information associated with the first blinkreflex and/or first blink period of the subject (e.g., BT1) with theinformation associated with the second blink reflex and/or second blinkperiod (e.g., BTB1), to identify an amount of change in the blink reflexand/or blink period (e.g., ΔB1) under such conditions (e.g.,ΔB1=|BT1−BTB1|).

Additionally, or alternatively, blink reflex device 100 may, withrespect to conditions in which the subject is being stimulated (e.g.,using mechanical stimulation) and is being confounded, compare theinformation associated with the first blink reflex and/or blink periodof the subject (e.g., RT1 in the case of the right eye) with theinformation associated with the second blink reflex and/or blink period(e.g., RTB1), to identify an amount of change in the blink reflex and/orblink period of the right eye under such conditions (e.g.,ΔR1=|RT1−RTB1|). Additionally, or alternatively, blink reflex device 100may, with respect to conditions in which the subject is stimulated(e.g., using mechanical stimulation) but is not confounded, compare theinformation associated with the first blink reflex and/or blink periodof the subject (e.g., RT2 in the case of the right eye) with theinformation associated with the second blink reflex and/or blink period(e.g., RTB2), to identify an amount of change in the blink reflex and/orblink period of the right eye under such conditions (e.g.,ΔR2=|RT2−RTB2|).

Blink reflex device 100 may perform a similar comparison for the righteye, left eye and/or both eyes for other conditions associated withdifferent types of stimuli (e.g., light, acoustic, electrical, etc.)with and/or without confounding the subject and may determine the amountof change or difference in the blink reflex and/or blink period of thesubject.

Additionally, or alternatively, blink reflex device 100 may, undercertain conditions, compare information associated with the first blinkreflex or blink period for the right eye with information associatedwith the first blink reflex and/or blink period for the left eye toidentify any asymmetry in such first blink reflexes. For example, blinkreflex device 100 may, with respect to conditions in which the subjectis stimulated (e.g., using mechanical stimulation) and is confounded,compare the information associated with the first blink reflex and/orblink period for the right eye (e.g., RT1) with the informationassociated with the first blink reflex and/or blink period for the lefteye (e.g., LT1) to identify an amount of difference in the first blinkreflex and/or blink period of the right eye relative to that of the lefteye (e.g., ΔLR1) under such conditions (e.g., ΔLR1=|RT1−LT1|). Blinkreflex device 100 may perform a similar comparison for other conditionsassociated with different types of stimuli (e.g., light, acoustic,electrical, etc.) with or without confounding the subject and maydetermine the amounts of difference in the first blink reflex betweenthe ipsilateral eye and contralateral eyes of the subject. Additionally,or alternatively, blink reflex device 100 may store one or more values,associated with the change in blink reflex and/or blink period in firstblink reflex in data structure 1100 of FIG. 11 .

As shown in FIG. 10 , if the amount of change or difference in the blinkreflex is less than a first threshold, and not greater than or equal toa second threshold (block 1050—YES<FIRST THRESHOLD), process 1000 mayinclude outputting an indication that brain injury is unlikely (block1055). For example, blink reflex device 100 may determine whether theamount of change in the blink reflex and/or blink period, of thesubject, before and after the subject experiences trauma (e.g., a blowto the head, etc.) is less than a first threshold. In the event that theamount of change is less than the first threshold, blink reflex device100 may output an indication that it is unlikely that the subjectsuffers from a neurological condition. Such an indication may enable theuser, of blink reflex device 100, to decide to allow the subject toresume normal activity, such as, for example, return to the playingfield, operate an automobile, return to work, etc.

For example, blink device 100 may retrieve, from a data structure (e.g.,data structure 1200 of FIG. 12 ) within a memory associated with blinkreflex device 100, server 120, and/or database 130, informationidentifies one or more thresholds, associated with conditions underwhich information associated with a blink reflex is obtained from asubject. The thresholds may be used by blink reflex device 100 todetermine if the subject suffers from a neurological condition and/orthe severity thereof. As shown in FIG. 12 , data structure 1200 mayinclude a collection of fields such as a no impairment field 1210, andsome impairment field 1215, and a significant impairment field 1220. Thenumber of fields illustrated in FIG. 12 , is provided for explanatorypurposes only. In practice, there may be additional fields; fewerfields; different fields; or differently arranged fields thanillustrated in FIG. 12 .

No impairment field 1210 may store information that identifies a firstthreshold (e.g., shown as br1, nbr1, c1, nc1, clr1, cnlr1, etc. in FIG.12 ) that corresponds to a time period, associated with a change inblink reflex and/or blink period, below which would indicate that thesubject does not suffer from a neurological condition. For example, ifthe change in blink reflex of the subject is less than a first thresholdfor the conditions measured by blink reflex device 100, blink reflexdevice 100 may determine that it is not likely that the subject issuffering from a brain injury or degenerative neurological impairment.

Some impairment field 1215 may store information that identifies a rangeof time, from a first threshold to a second threshold (e.g., shown asbr2, nbr2, c1, nc2, clr2, cnlr2, etc. in FIG. 12 ), associated with achange in blink reflex and/or blink period, within which would indicatethat the subject is suffering from a neurological condition. The secondthreshold may be greater than the first threshold. For example, if thechange in blink reflex of the subject is not less than a first thresholdand is less than a second threshold for the conditions measured by blinkreflex device 100, blink reflex device 100 may determine that it islikely that the subject is suffering from a brain injury or degenerativeneurological impairment.

Significant impairment field 1220 may store information that identifiesthe second threshold that corresponds to a time period, associated witha change in blink reflex and/or blink period, above which would indicatethat the subject is suffering from a significant brain injury ordegenerative neurological condition. For example, if the change in blinkreflex of the subject is not less than a second threshold, blink reflexdevice 100 may determine that it is likely that the subject is sufferingfrom a significant neurological condition.

Returning to FIG. 10 and by way of example, with respect to conditionsin which the subject is not stimulated or confounded, blink reflexdevice 100 may determine whether the amount of change in blink reflexand/or blink period (e.g., ΔB0) is less than a first threshold (e.g.,br1) associated with such conditions (e.g., shown as ΔB0<br1 in noimpairment field 1210 of FIG. 12 ), where br1 represents the firstthreshold for conditions in which the subject is not stimulated orconfounded). In the event that the amount of change is less than thefirst threshold, blink reflex device 100 may output an indication thatit is unlikely that the subject suffers from a neurological condition.Additionally, or alternatively, with respect to conditions in which thesubject is not stimulated but is confounded, blink reflex device 100 maydetermine whether the amount of change in blink reflex and/or blinkperiod (e.g., ΔB1) is less than a first threshold associated with suchconditions (e.g., shown as ΔB1<nbr1 in no impairment field 1210 of FIG.12 , where nbr1 represents the first threshold for conditions in whichthe subject is not stimulated but is confounded).

Additionally, or alternatively, with respect to conditions in which thesubject is stimulated and confounded, blink reflex device 100 maydetermine whether the amount of change in blink reflex and/or blinkperiod (e.g., ΔR1 for the right eye or ΔL1 for the left eye) is lessthan a first threshold associated with such conditions (e.g., shown asΔR1<c1 or ΔL1<c1 in no impairment field 1210 of FIG. 12 , where c1represents the first threshold for conditions in which the subject isstimulated and confounded). The change in blink reflex and/or blinkperiod for conditions associated with other types of stimuli (e.g.,light, acoustic, electrical, etc.) and confounding may be compared, inthe manner described above, to other first thresholds for suchconditions associated with the other types of stimuli and confounding.

Additionally, or alternatively, with respect to conditions in which thesubject is stimulated but not confounded, blink reflex device 100 maydetermine whether the amount of change in blink reflex and/or blinkperiod (e.g., ΔR2 for the right eye or ΔL2 for the left eye) is lessthan a first threshold associated with such conditions (e.g., shown asΔR2<nc1 or ΔL2<nc1 in no impairment field 1210 of FIG. 12 , where nc1represents the first threshold for conditions in which the subject isstimulated but not confounded). The change in blink reflex and/or blinkperiod for conditions associated with other types of stimuli (e.g.,light, acoustic, electrical, etc.) but no confounding may be compared,in the manner described above, to other first thresholds for suchconditions associated with the other types of stimuli and noconfounding.

Additionally, or alternatively, with respect to conditions in which thesubject is stimulated and confounded, blink reflex device 100 maydetermine whether the amount of difference between the first blinkreflex and/or blink period of the ipsilateral and contralateral eye(e.g., ΔLR1) is less than a first threshold associated with suchconditions (e.g., shown as ΔLR1<clr1 in no impairment field 1210 of FIG.12 , where clr1 may represent the first threshold for conditions inwhich the subject is stimulated and confounded). The change in the firstblink reflex between the ipsilateral and contralateral eye forconditions associated with other types of stimuli (e.g., light,acoustic, electrical, etc.) and confounding may be compared, in themanner described above, to other first thresholds for such conditionsassociated with the other types of stimuli and confounding.Additionally, or alternatively, with respect to conditions in which thesubject is stimulated but not confounded, blink reflex device 100 maydetermine whether the amount of difference between the first blinkreflex and/or blink period of the ipsilateral and contralateral eye(e.g., ΔLR2) is less than a first threshold associated with suchconditions (e.g., shown as ΔLR2<nclr1 in no impairment field 1210 ofFIG. 12 , where nclr1 may represent the first threshold for conditionsin which the subject is stimulated but not confounded).

The change in the first blink reflex between the ipsilateral andcontralateral eye for conditions associated with other types of stimuli(e.g., light, acoustic, electrical, etc.) and confounding may becompared, in the manner described above, to other first thresholds forsuch conditions associated with the other types of stimuli andconfounding. In the event that each of the amounts of change in blinkreflex and/or blink period are less than the respective first thresholdsas described above, blink reflex device 100 may output an indicationthat it is unlikely that the subject suffers from a neurologicalcondition. Additionally, or alternatively, if the difference in firstblink reflex, between the ipsilateral and contralateral eye, is lessthan the corresponding first threshold, blink reflex device 100 mayoutput an indication that it is unlikely that the subject suffers from aneurological condition.

As also shown in FIG. 10 , if the change in the blink reflex is not lessthan the first threshold or not greater than or equal to the secondthreshold (block 1050—NO), process 1000 may include outputting anindication that brain injury is likely (block 1060). For example, blinkreflex device 100 may determine whether the amount of change in theblink reflex and/or blink period, of the subject, before and after thesubject experiences trauma indicates that the subject has suffered abrain injury and/or a degenerative neurological condition. Based on adetermination that the subject suffers from a brain injury and/or adegenerative neurological condition, blink reflex device 100 may outputan indication that it is likely that the subject suffers from aneurological condition. Such an indication may enable the user, of blinkreflex device 100, to decide to prohibit the subject from resumingnormal activity, such as, for example, prohibiting a subject fromreturning to the playing field, operating an automobile, returning towork, etc.

For example, with respect to conditions in which the subject is notstimulated or confounded, blink reflex device 100 may determine whetherthe amount of change in blink reflex and/or blink period (e.g., ΔB0) isnot less than the first threshold (e.g., br1) associated with suchconditions and is not greater than or equal to a second thresholdassociated with such conditions (e.g., shown as br1≤ΔB0<br2 in someimpairment field 1215 of FIG. 12 , where br2 represents the secondthreshold for conditions in which the subject is not stimulated orconfounded). In the event that the amount of change is not less than thefirst threshold and is not greater than or equal to the secondthreshold, blink reflex device 100 may output an indication that it islikely that the subject suffers from a neurological condition.Additionally, or alternatively, with respect to conditions in which thesubject is not stimulated but is confounded, blink reflex device 100 maydetermine whether the amount of change in blink reflex and/or blinkperiod (e.g., ΔB1) is not less than a first threshold associated withsuch conditions and is not greater than or equal to a second thresholdassociated with such conditions (e.g., shown as nbr1≤ΔB1<nbr2 in someimpairment field 1215 of FIG. 12 , where nbr2 represents the secondthreshold for conditions in which the subject is not stimulated but isconfounded).

Additionally, or alternatively, with respect to conditions in which thesubject is stimulated and confounded, blink reflex device 100 maydetermine whether the amount of change in blink reflex and/or blinkperiod (e.g., ΔR1 for the right eye or ΔL1 for the left eye) is not lessthan a first threshold associated with such conditions and is notgreater than or equal to a second threshold associated with suchconditions (e.g., shown as c1≤ΔR1<c2 in some impairment field 1215 ofFIG. 12 , where c2 represents the second threshold for conditions inwhich the subject is stimulated and confounded) (e.g., shown asc1≤ΔL1<c2 in some impairment field 1215 of FIG. 12 ). The change inblink reflex for conditions associated with other types of stimuli(e.g., light, acoustic, electrical, etc.) and confounding may becompared, in the manner described above, to other first thresholds andsecond thresholds for such conditions associated with the other types ofstimuli and confounding.

Additionally, or alternatively, with respect to conditions in which thesubject is stimulated but not confounded, blink reflex device 100 maydetermine whether the amount of change in blink reflex and/or blinkperiod (e.g., ΔR2 for the right eye or ΔL2 for the left eye) is not lessthan a first threshold associated with such conditions and is notgreater than or equal to a second threshold associated with suchconditions (e.g., shown as nc1≤ΔR2<nc2 in some impairment field 1215 ofFIG. 12 , where nc2 represents the second threshold for conditions inwhich the subject is stimulated but not confounded) (e.g., shown asnc1≤ΔL2<nc2 in some impairment field 1215 of FIG. 12 ). The change inblink reflex for conditions associated with other types of stimuli(e.g., light, acoustic, electrical, etc.) but no confounding may becompared, in the manner described above, to other first thresholds andsecond thresholds for such conditions associated with the other types ofstimuli and confounding.

Additionally, or alternatively, with respect to conditions in which thesubject is stimulated and confounded, blink reflex device 100 maydetermine whether the amount of difference between the first blinkreflex and/or blink period of the ipsilateral and contralateral eye(e.g., ΔLR1) is not less than a first threshold associated with suchconditions and not greater than or equal to a second thresholdassociated with such conditions (e.g., shown as clr1≤ΔLR1<clr2 in someimpairment field 1215 of FIG. 12 , where clr2 represents the secondthreshold for conditions in which the subject is stimulated andconfounded). The change in the first blink reflex between theipsilateral and contralateral eye for conditions associated with othertypes of stimuli (e.g., light, acoustic, electrical, etc.) andconfounding may be compared, in the manner described above, to otherfirst thresholds and/or second thresholds for such conditions associatedwith the other types of stimuli and confounding. Additionally, oralternatively, with respect to conditions in which the subject isstimulated but not confounded, blink reflex device 100 may determinewhether the amount of difference between the first blink reflex and/orblink period of the ipsilateral and contralateral eye (e.g., ΔLR2) isnot less than a first threshold associated with such conditions and isnot greater than or equal to a second threshold associated with suchconditions (e.g., shown as nclr1≤ΔLR2<nclr2 in some impairment field1215 of FIG. 12 , where nclr2 represents the second threshold forconditions in which the subject is stimulated but not confounded). Thechange in the first blink reflex and/or blink period between theipsilateral and contralateral eye for conditions associated with othertypes of stimuli (e.g., light, acoustic, electrical, etc.) andconfounding may be compared, in the manner described above, to otherfirst thresholds for such conditions associated with the other types ofstimuli and confounding.

In the event that each of the amounts of change in blink reflex are notless than the respective first thresholds and are not greater than orequal to the respective second thresholds as described above, blinkreflex device 100 may output an indication that it is likely that thesubject suffers from a neurological condition. Additionally, oralternatively, if the difference in first blink reflex, between theipsilateral and contralateral eye, is not less than the correspondingfirst threshold and is not greater than or equal to the correspondingsecond threshold, blink reflex device 100 may output an indication thatit is likely that the subject suffers from a neurological condition.

As further shown in FIG. 10 , if the change in the blink reflex is notless than the first threshold and is greater than or equal to the secondthreshold (block 1050—YES≥SECOND THRESHOLD), process 1000 may includeoutputting an indication that significant brain injury is likely (block1065). For example, blink reflex device 100 may determine whether theamount of change in the blink reflex and/or blink period of the subject,before and after the subject experiences trauma, indicates that thesubject is suffering from a significant neurological condition. Based ona determination that the subject suffers from a significant neurologicalcondition, blink reflex device 100 may output an indication that it islikely that the subject suffers from a significant neurologicalcondition. Such an indication may en able the user, of blink reflexdevice 100, to decide to prohibit the subject from resuming normalactivity and/or by seeking immediate medical treatment for the subject.

For example, with respect to conditions in which the subject is notstimulated or confounded, blink reflex device 100 may determine whetherthe amount of change in blink reflex and/or blink period (e.g., ΔB0) isgreater than or equal to a second threshold (e.g., br2) associated withsuch conditions (e.g., shown as br2≤ΔB0 in significant impairment field1220 of FIG. 12 ). In the event that the amount of change is greaterthan or equal to the second threshold, blink reflex device 100 mayoutput an indication that it is likely that the subject suffers from asignificant neurological condition. Additionally, or alternatively, withrespect to conditions in which the subject is not stimulated but isconfounded, blink reflex device 100 may determine whether the amount ofchange in blink reflex and/or blink period (e.g., ΔB1) is greater thanor equal to a second threshold associated with such conditions (e.g.,shown as nbr2≤ΔB1 in significant impairment field 1220 of FIG. 12 ).

Additionally, or alternatively, with respect to conditions in which thesubject is stimulated and confounded, blink reflex device 100 maydetermine whether the amount of change in blink reflex and/or blinkperiod (e.g., ΔR1 for the right eye or ΔL1 for the left eye) is greaterthan or equal to a second threshold associated with such conditions(e.g., shown as c2≤ΔR1 or c2≤ΔL1 in significant impairment field 1220 ofFIG. 12 ). The change in blink reflex and/or blink period for conditionsassociated with other types of stimuli (e.g., light, acoustic,electrical, etc.) and confounding may be compared, in the mannerdescribed above, to other second thresholds for such conditionsassociated with the other types of stimuli and confounding.

Additionally, or alternatively, with respect to conditions in which thesubject is stimulated but not confounded, blink reflex device 100 maydetermine whether the amount of change in blink reflex and/or blinkperiod (e.g., ΔR2 for the right eye or ΔL2 for the left eye) is greaterthan or equal to a second threshold associated with such conditions(e.g., shown as nc2≤ΔR2 or nc2≤ΔL2 in no impairment field 1210 of FIG.12 ). The change in blink reflex and/or blink period for conditionsassociated with other types of stimuli (e.g., light, acoustic,electrical, etc.) but no confounding may be compared, in the mannerdescribed above, to other second thresholds for such conditionsassociated with the other types of stimuli and no confounding.

Additionally, or alternatively, with respect to conditions in which thesubject is stimulated and confounded, blink reflex device 100 maydetermine whether the amount of difference between the first blinkreflex and/or blink period of the ipsilateral eye and contralateral eye(e.g., ΔLR1) is greater than or equal to a second threshold associatedwith such conditions (e.g., shown as clr1≤ΔLR1 in significant impairmentfield 1220 of FIG. 12 ). The change in the first blink reflex and/orblink period between the ipsilateral eye and contralateral eye forconditions associated with other types of stimuli (e.g., light,acoustic, electrical, etc.) and confounding may be compared, in themanner described above, to other second thresholds for such conditionsassociated with the other types of stimuli and confounding.Additionally, or alternatively, with respect to conditions in which thesubject is stimulated but not confounded, blink reflex device 100 maydetermine whether the amount of difference between the first blinkreflex and/or blink period of the ipsilateral eye and contralateral eye(e.g., ΔLR2) is greater than or equal to a second threshold associatedwith such conditions (e.g., shown as nclr1≤ΔLR2 in significantimpairment field 1220 of FIG. 12 ). The change in the first blink reflexand/or blink period between the ipsilateral eye and contralateral eyefor conditions associated with other types of stimuli (e.g., light,acoustic, electrical, etc.) and confounding may be compared, in themanner described above, to other second thresholds for such conditionsassociated with the other types of stimuli and confounding.

In the event that each of the amounts of change in blink reflex and/orblink period are greater than or equal to the respective secondthresholds as described above, blink reflex device 100 may output anindication that it is likely that the subject suffers from a significantneurological condition. Additionally, or alternatively, if thedifference in first blink reflex, between the ipsilateral eye andcontralateral eye, is greater than or equal to the corresponding secondthreshold, blink reflex device 100 may output an indication that it islikely that the subject suffers from a significant neurologicalcondition.

The foregoing description provides illustration and description, but isnot intended to be exhaustive or to limit the implementations to theprecise form disclosed. Modifications and variations are possible inlight of the above teachings or may be acquired from practice of theimplementations.

While a series of blocks have been described with regard to FIG. 10 ,the order of the blocks may be modified in other implementations.Further, non-dependent blocks may be performed in parallel.

It will be apparent that devices and methods, as described above, may beimplemented in many different forms of hardware, equipment, devices,systems, mechanical interconnections, and/or electrical interconnectionsin the implementations illustrated in the figures. The actual hardware,equipment, devices, systems, mechanical interconnections, and/orelectrical interconnections used to implement these systems and methodsis not limiting of the implementations—it being understood thathardware, equipment, devices, systems, mechanical interconnections,and/or electrical interconnections can be designed to implement thesystems and methods based on the description herein. Further, certainportions, described above, may be implemented as a component thatperforms one or more functions.

Further, certain portions, described above, may be implemented as acomponent that performs one or more functions. A component, as usedherein, may include hardware, such as a processor, an applicationspecific integrated circuit (ASIC), or a field programmable gate array(FPGA), or a combination of hardware and software (e.g., a processorexecuting software).

It should be emphasized that the terms “comprises”/“comprising” whenused in this specification are taken to specify the presence of statedfeatures, integers, steps or components but does not preclude thepresence or addition of one or more other features, integers, steps,components or groups thereof.

Even though particular combinations of features are recited in theclaims and/or disclosed in the specification, these combinations are notintended to limit the disclosure of the implementations. In fact, manyof these features may be combined in ways not specifically recited inthe claims and/or disclosed in the specification. Although eachdependent claim listed below may directly depend on only one otherclaim, the disclosure of the implementations includes each dependentclaim in combination with every other claim in the claim set.

No element, act, or instruction used in the present application shouldbe construed as critical or essential to the implementations unlessexplicitly described as such. Also, as used herein, the article “a” and“an” are intended to include one or more items and may be usedinterchangeably with “one” or “more.” Where only one item is intended,the term “one” or similar language is used. Further, the phrase “basedon” is intended to mean “based, at least in part, on” unless explicitlystated otherwise.

What is claimed is:
 1. A method for measuring a blink of a subject, themethod comprising: providing a blink measurement device having a sensorunit configured to measure eyelid movement of the subject; designating afirst eyelid tracking point on an eyelid of the subject; tracking thefirst eyelid tracking point by measuring a first and second position ofthe first eyelid tracking point at different times; designating a secondeyelid tracking point on an eyelid of the subject; tracking the secondeyelid tracking point by measuring a first and second position of thesecond eyelid tracking point at the different times; defining a blinkaxis that intersects the first and second eyelid tracking points,wherein tracking the first and second eyelid tracking points comprisestracking movement along the blink axis; generating a corneal reflectionalong the blink axis; detecting a change in corneal reflection along theblink axis; and determining a blink of the subject based on the trackingthe at least one first eyelid tracking point, tracking the second eyelidtracking point, and detecting the change in corneal reflection.
 2. Themethod of claim 1, wherein the first eyelid tracking point is an uppereyelid tracking point.
 3. The method of claim 2, wherein the secondeyelid tracking point is a lower eyelid tracking point.
 4. The method ofclaim 1, wherein tracking the first or second eyelid tracking pointcomprises measuring different positions at the different times.
 5. Themethod of claim 1, wherein tracking the first or second eyelid trackingpoint comprises measuring the same position at the different times. 6.The method of claim 1 further comprising: measuring and designating aninitial position of the first eyelid tracking point; and first comparingthe initial position of the first eyelid tracking point with a pluralityof subsequently measured positions of the first eyelid tracking point.7. The method of claim 6 further comprising: determining whether aneyelid is in a closing stage based on the first comparing.
 8. The methodof claim 6 further comprising: determining whether an eyelid is in aclosed stage based on the first comparing.
 9. The method of claim 6further comprising: determining whether an eyelid is an on opening stagebased on the first comparing.
 10. The method of claim 6 furthercomprising: measuring and designating an initial position of the secondeyelid tracking point; and second comparing the initial position of thesecond eyelid tracking point with a plurality of subsequently measuredpositions of the second eyelid tracking point.
 11. The method of claim10 further comprising: determining whether an eyelid is in a closingstage based on the first and second comparing.
 12. The method of claim10 further comprising: determining whether an eyelid is in a closedstage based on the first and second comparing.
 13. The method of claim10 further comprising: determining whether an eyelid is in an openingstage based on the first and second comparing.
 14. The method of claim 1further comprising: determining whether the tracking the first eyelidtracking point is greater than a first threshold, and generating anoutput indicating that a condition is likely when the tracking the firsteyelid tracking point is greater than the first threshold.
 15. Themethod of claim 1 further comprising: determining whether the trackingthe first eyelid tracking point is less than a second threshold; andgenerating an output indicating that a condition is unlikely when thetracking the first eyelid tracking point is less than the secondthreshold.
 16. The method of claim 1, wherein the different times arebased on a frame rate.
 17. The method of claim 1, wherein the differenttimes are based on a scan rate.
 18. The method of claim 1 furthercomprising: generating a blink function based on the tracking the firsteyelid tracking point.
 19. The method of claim 18 further comprising:detecting an abnormal blink based on the blink function.
 20. The methodof claim 18 further comprising: determining that the subject did notblink based on the blink function.
 21. The method of claim 1, whereinthe blink measurement device comprises a stimulator, the method furthercomprising: stimulating an involuntary blink reflex.
 22. The method ofclaim 21, wherein the stimulating comprises generating a puff of air.23. The method of claim 21, wherein the stimulating comprises generatinga puff of fluid.
 24. The method of claim 21 further comprising:determining an involuntary blink reflex reaction time based on a reflextime associated with both the stimulating and the determining a blink ofthe subject.
 25. The method of claim 21, wherein the stimulating is atleast partially deployed within a cavity of the blink measurementdevice.
 26. The method of claim 25, wherein the cavity is configured toat least partially interface with a region of the subject's face suchthat the subject's eyelids can position at least partially within thecavity.
 27. The method of claim 1, wherein the first eyelid trackingpoint is designated based on a detected corneal reflection.
 28. Themethod of claim 1, wherein the first eyelid tracking point is designatedbased on a detected edge of an iris.
 29. The method of claim 1, whereinthe first eyelid tracking point is designated based on a detected edgeof a pupil.
 30. The method of claim 1, wherein the first eyelid trackingpoint is one of a plurality of upper eyelid tracking points.
 31. Themethod of claim 30, wherein each of the plurality of upper eyelidtracking points is paired with a corresponding lower eyelid trackingpoint.
 32. The method of claim 1, wherein the sensor unit comprises oneor more of a camera, photodiode, electro-optical sensor, infraredsensor, ultraviolet sensor, laser diode sensor, electrode sensor, focalplan array and antenna.